Risk Factors for Neonatal Clavicular Fractures: A Population-Based Case-Control Study.

J Perinat Neonatal Nurs

Author Affiliations: Roth McFarlane Hand and Upper Limb Centre, St Joseph's Hospital, London, Ontario, Canada (Dr Kadar); Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada (Dr Kadar); Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel (Ms Yaniv);

Published: April 2025


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Article Abstract

Background: Neonatal clavicular fractures represent the most common fracture during delivery. We aimed to define risk factors associated with these fractures in a large population-based database.

Methods: Data were extracted from Clalit Health Services' electronic health records from 2000 to 2020. Newborns with clavicular fractures were compared with a healthy control group. The following parameters were compared-for the newborns: sex, birth weight, birth height, and head circumference; for the delivery process: assisted delivery, cesarean section, use of epidural, birth week, and number of fetuses; and for the mother: age at delivery, socioeconomic status, height, weight, and body mass index (BMI).

Results: We found a rate of 0.28% for neonatal clavicular fractures (5015 clavicular fractures/1 755 660 deliveries). Male gender and heavier birth weight were found to be significantly associated with clavicular fractures ( P < .001). Increased risk was also associated with lower socioeconomic status, baseline weight, and maternal BMI ( P < .001 for all). Assisted delivery increased the risk of clavicular fracture (OR = 2.274; 95% CI, 1.661-3.115; P < .0001), while cesarean section and use of epidural were found to be protective (OR = 0.149; 95% CI, 0.086-0.26; P < .0001; and OR = 0.687; 95% CI, 0.0531-0.89; P < .004, respectively).

Conclusions: This study provides insight into the risk factors associated with neonatal clavicular fractures on the largest group of patients reported to date.

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http://dx.doi.org/10.1097/JPN.0000000000000805DOI Listing

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