{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:07:19Z","timestamp":1784783239000,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A clavicle fracture is one of the most common birth injuries. The objective of this study was to examine whether the decreased incidence of birth\u2010related clavicle fractures in Finland is because of temporal changes in their predisposing factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For this nationwide population\u2010based study, we used the Finnish Medical Birth Register and the Care Register for Health Care databases. The study population included all singleton, live\u2010born newborn born spontaneously or by vacuum\u2010assisted delivery, in cephalic presentation \u226537<jats:sup>+0<\/jats:sup> weeks of gestation. The incidences of clavicle fractures, pregnancy characteristics, and risk assessments for fracture were calculated and compared between two time periods: 2004\u20132010 and 2011\u20132017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 629\u2009457 newborn were born vaginally between 2004 and 2017. The clavicle fracture incidence decreased from 17.6\/1000 to 6.2\/1000 live births. Shoulder dystocia, diabetes, and birthweight \u22654000 g were the strongest predisposing factors. The incidence of birthweight \u22654000 g decreased, meanwhile type 1 diabetes and shoulder dystocia remained stable and gestational diabetes, type 2 diabetes, and maternal obesity increased in the later study period. The incidence of clavicle fractures without known predisposing factors declined. Simultaneously, the cesarean birth rate remained stable (13.2%\u201313.1%), although the rate of vacuum\u2010assisted deliveries increased (8.5%\u20139.5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The incidence of clavicle fractures decreased, even though the incidence of most risk factors remained stable or increased, and the cesarean birth rate remained stable. This decline may be related to the reduction of fracture incidence among deliveries without known risk factors, and the decrease in birthweight \u22654000\u2009g.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12662","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T09:49:33Z","timestamp":1655977773000},"page":"428-437","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Incidence changes in risk factors associated with the decreasing number of birth\u2010related clavicle fractures in Finland: A nationwide retrospective birth cohort from 2004 to 2017"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3316-7021","authenticated-orcid":false,"given":"Maiju","family":"Kekki","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Tampere University Hospital  Tampere Finland"},{"name":"Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Salonen","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Surgery Tampere University Hospital  Tampere Finland"},{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Topias","family":"Koukkula","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Orthopaedics and Traumatology Tampere University Hospital  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannele","family":"Laivuori","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Tampere University Hospital  Tampere Finland"},{"name":"Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Institute for Molecular Medicine Finland Helsinki Institute of Life Science, University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kati","family":"Tihtonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Tampere University Hospital  Tampere Finland"},{"name":"Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomas\u00a0T.","family":"Huttunen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Tampere University Heart Hospital Tampere University Hospital  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2019.1631770"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15267"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.11.006"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2009.01077.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.12497"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1222368"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7210594"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15217"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00545.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-018-4924-0"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2011.01576.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-46179-8"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(98)00127-1"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)30217-0"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13074"},{"key":"e_1_2_9_17_1","unstructured":"Eurostat.Fertility statistics.https:\/\/ec.europa.eu\/eurostat\/statistics\u2010explained\/index.php\/Fertilitystatistics. 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