M Claire Manske, Machelle D Wilson, Barton L Wise, Herman L Hedriana, Joy Melnikow, Daniel J Tancredi
{"title":"Are racial and ethnic disparities in brachial plexus birth injuries explained by known risk factors?","authors":"M Claire Manske, Machelle D Wilson, Barton L Wise, Herman L Hedriana, Joy Melnikow, Daniel J Tancredi","doi":"10.1038/s41372-025-02239-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association of maternal race/ethnicity with risk factors for brachial plexus birth injury (BPBI) and quantify the proportion of excess BPBI risk due to these factors.</p><p><strong>Study design: </strong>This retrospective cohort study of all livebirths occurring in California-licensed hospitals from 1996-2012 included 6,278,562 maternal-livebirth infant pairs with 7762 BPBI diagnoses. Multiple logistic regression and causal mediation analyses were used to evaluate the relationship of race/ethnicity and BPBI risk factors.</p><p><strong>Results: </strong>Black and Hispanic birthing-individuals were at increased risk of obesity, diabetes, and limited prenatal care utilization but decreased risk of many BPBI risk factors (shoulder dystocia, macrosomia, prolonged second stage of labor, and vaginal delivery).</p><p><strong>Conclusions: </strong>Black and Hispanic birthing-individuals were at lower risk of many strongly associated risk factors for BPBI, and these factors mediate only a small proportion of their excess BPBI risk, underscoring the importance of identifying alternative risk factors, especially drivers of demographic disparities.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41372-025-02239-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To investigate the association of maternal race/ethnicity with risk factors for brachial plexus birth injury (BPBI) and quantify the proportion of excess BPBI risk due to these factors.
Study design: This retrospective cohort study of all livebirths occurring in California-licensed hospitals from 1996-2012 included 6,278,562 maternal-livebirth infant pairs with 7762 BPBI diagnoses. Multiple logistic regression and causal mediation analyses were used to evaluate the relationship of race/ethnicity and BPBI risk factors.
Results: Black and Hispanic birthing-individuals were at increased risk of obesity, diabetes, and limited prenatal care utilization but decreased risk of many BPBI risk factors (shoulder dystocia, macrosomia, prolonged second stage of labor, and vaginal delivery).
Conclusions: Black and Hispanic birthing-individuals were at lower risk of many strongly associated risk factors for BPBI, and these factors mediate only a small proportion of their excess BPBI risk, underscoring the importance of identifying alternative risk factors, especially drivers of demographic disparities.
期刊介绍:
The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development.
The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.