Brachial plexus birth palsy: incidence, natural-course, and prognostic factors during the first year of life

Objective: To evaluate the incidence of brachial plexus birth palsy (BPBP) in a large, single cohort and stratify clinical 1-year outcomes. Study design: A cohort study of all births occurring at a single institution between 2011 and 2015. Hospital discharge papers were analyzed, and structured telephone interviews were conducted. Results: Among 76,000 livebirths, 98 (0.13%) cases of BPBP were diagnosed. Of cases who fully responded to interview (66/98), at 3 months of age 77% infants made a complete recovery, and by 1 year of age an additional 20% had recovered completely. Only 3% of infants had residual longer-term neurological deficits. Conclusions: Predictors of a longer course of recovery were the presence of shoulder dystocia (p< 0.04) and right-sided palsy (p< 0.02). Birth weight, neonatal head circumference, and sex were not correlated with outcome. Future reports of BPBP should differentiate between infants showing early recovery from those with true BPBP.