{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T13:46:52Z","timestamp":1774360012447,"version":"3.50.1"},"reference-count":43,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Neonatal brachial plexus palsy (NBPP) occurs due to the stretching of the nerves of the brachial plexus before, during, or after delivery. NBPP can resolve spontaneously or become persistent. To determine if nerve surgery is indicated, predicting recovery is necessary but difficult. Historical attempts explored the association of recovery with only clinical and electrodiagnostic examinations. However, no data exist regarding the neonatal and peripartum factors associated with NBPP persistence.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This retrospective cohort study involved all NBPP patients at the University of Michigan between 2005 and 2015. Peripartum and neonatal factors were assessed for their association with persistent NBPP at 1 year, as defined as the presence of musculoskeletal contractures or an active range of motion that deviated from normal by &gt; 10\u00b0 (shoulder, elbow, hand, and finger ranges of motion were recorded). Standard statistical methods were used.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Of 382 children with NBPP, 85% had persistent NBPP at 1 year. A wide range of neonatal and peripartum factors was explored. We found that cephalic presentation, induction or augmentation of labor, birth weight &gt; 9 lbs, and the presence of Horner syndrome all significantly increased the odds of persistence at 1 year, while cesarean delivery and Narakas Grade I to II injury significantly reduced the odds of persistence.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Peripartum\/neonatal factors were identified that significantly altered the odds of having persistent NBPP at 1 year. Combining these peripartum\/neonatal factors with previously published clinical examination findings associated with persistence should allow the development of a prediction algorithm. The implementation of this algorithm may allow the earlier recognition of those cases likely to persist and thus enable earlier intervention, which may improve surgical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.10.peds15543","type":"journal-article","created":{"date-parts":[[2016,1,22]],"date-time":"2016-01-22T15:40:53Z","timestamp":1453477253000},"page":"618-624","source":"Crossref","is-referenced-by-count":19,"title":["Peripartum and neonatal factors associated with the persistence of neonatal brachial plexus palsy at 1 year: a review of 382 cases"],"prefix":"10.3171","volume":"17","author":[{"given":"Thomas J.","family":"Wilson","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate W. C.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suneet P.","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynda J. S.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds15543","series-title":"Obstet Gynecol","first-page":"902","article-title":"Executive summary: Neonatal brachial plexus palsy. Report of the American College of Obstetricians and Gynecologists' Task Force on Neonatal Brachial Plexus Palsy","volume":"123","author":"American College of Obstetricians and Gynecologists","year":"2014"},{"key":"b2-peds15543","series-title":"BioMed Res Int","first-page":"627067","article-title":"Extending the indications for primary nerve surgery in obstetrical brachial plexus palsy","volume":"2014","author":"Bade","year":"2014"},{"key":"b3-peds15543","series-title":"Acta Paediatr","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1111\/j.1651-2227.1997.tb14849.x","article-title":"Perinatally acquired brachial plexus palsy\u2014a persisting challenge","volume":"86","author":"Bager","year":"1997"},{"key":"b4-peds15543","series-title":"J Hand Surg Br","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jhsb.2003.10.018","article-title":"The towel test: a useful technique for the clinical and electromyographic evaluation of obstetric brachial plexus palsy","volume":"29","author":"Bertelli","year":"2004"},{"key":"b5-peds15543","series-title":"J Hand Surg Br","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/S0266-7681(02)00281-4","article-title":"Neurophysiological prediction of outcome in obstetric lesions of the brachial plexus","volume":"28","author":"Bisinella","year":"2003"},{"issue":"1 Suppl","key":"b6-peds15543","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"144e","DOI":"10.1097\/PRS.0b013e3181a80798","article-title":"Obstetrical brachial plexus palsy","volume":"124","author":"Borschel","year":"2009"},{"key":"b7-peds15543","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1001\/archneur.1969.00480160114014","article-title":"Erb's palsy","volume":"21","author":"Brody","year":"1969"},{"key":"b8-peds15543","series-title":"Pediatr Neurol","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.pediatrneurol.2013.07.018","article-title":"Deficits in elbow position sense in neonatal brachial plexus palsy","volume":"49","author":"Brown","year":"2013"},{"key":"b9-peds15543","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"395","DOI":"10.3171\/2013.6.PEDS12630","article-title":"A systematic review of evaluation methods for neonatal brachial plexus palsy: a review","volume":"12","author":"Chang","year":"2013"},{"key":"b10-peds15543","series-title":"Pediatr Neurol","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/j.pediatrneurol.2014.04.021","article-title":"High prevalence of early language delay exists among toddlers with neonatal brachial plexus palsy","volume":"51","author":"Chang","year":"2014"},{"key":"b11-peds15543","series-title":"Ann Trop Paediatr","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1080\/02724936.1997.11747886","article-title":"Risk factors and prognosis for brachial plexus injury and clavicular fracture in neonates: a prospective analysis from the United Arab Emirates","volume":"17","author":"Dawodu","year":"1997"},{"key":"b12-peds15543","series-title":"Obstet Gynecol","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1097\/01.AOG.0000137347.94987.01","article-title":"Evaluation of residents' delivery notes after a simulated shoulder dystocia","volume":"104","author":"Deering","year":"2004"},{"key":"b13-peds15543","series-title":"Obstet Gynecol","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1097\/AOG.0b013e3181e42220","article-title":"Improvement in documentation using an electronic checklist for shoulder dystocia deliveries","volume":"116","author":"Deering","year":"2010"},{"key":"b14-peds15543","series-title":"Arch Dis Child Fetal Neonatal Ed","doi-asserted-by":"publisher","first-page":"F185","DOI":"10.1136\/fn.88.3.F185","article-title":"Congenital brachial palsy: incidence, causes, and outcome in the United Kingdom and Republic of Ireland","volume":"88","author":"Evans-Jones","year":"2003"},{"key":"b15-peds15543","series-title":"J Child Orthop","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1007\/s11832-009-0208-3","article-title":"Prognosis following neonatal brachial plexus palsy: an evidence-based review","volume":"3","author":"Foad","year":"2009"},{"key":"b16-peds15543","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.2106\/JBJS.G.00853","article-title":"The epidemiology of neonatal brachial plexus palsy in the United States","volume":"90","author":"Foad","year":"2008"},{"key":"b17-peds15543","series-title":"Chirurgie","first-page":"70","article-title":"[Surgical repair of the brachial plexus in obstetric paralysis.]","volume":"110","author":"Gilbert","year":"1984"},{"key":"b18-peds15543","series-title":"Obstet Gynecol Clin North Am","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.ogc.2011.02.015","article-title":"Reducing the risk of shoulder dystocia and associated brachial plexus injury","volume":"38","author":"Gurewitsch","year":"2011"},{"key":"b19-peds15543","series-title":"Am J Obstet Gynecol","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1016\/j.ajog.2005.07.071","article-title":"Risk factors for brachial plexus injury with and without shoulder dystocia","volume":"194","author":"Gurewitsch","year":"2006"},{"key":"b20-peds15543","series-title":"J Matern Fetal Neonatal Med","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1080\/14767050600850498","article-title":"Etiological risk factors for brachial plexus palsy","volume":"19","author":"Hudi\u0107","year":"2006"},{"key":"b21-peds15543","series-title":"Clin Orthop Relat Res","first-page":"233","article-title":"Early microsurgical reconstruction in birth palsy","volume":"215","author":"Kawabata","year":"1987"},{"key":"b22-peds15543","series-title":"J Pediatr Rehabil Med","doi-asserted-by":"publisher","first-page":"141","DOI":"10.3233\/PRM-2011-0166","article-title":"Nerve surgery for neonatal brachial plexus palsy","volume":"4","author":"Malessy","year":"2011"},{"issue":"4 Suppl","key":"b23-peds15543","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"A153","DOI":"10.1227\/01.NEU.0000338429.66249.7D","article-title":"Electromyography, nerve action potential, and compound motor action potentials in obstetric brachial plexus lesions: validation in the absence of a \u201cgold standard\u201d","volume":"65","author":"Malessy","year":"2009"},{"key":"b24-peds15543","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e26193","DOI":"10.1371\/journal.pone.0026193","article-title":"Severe obstetric brachial plexus palsies can be identified at one month of age","volume":"6","author":"Malessy","year":"2011"},{"key":"b25-peds15543","series-title":"The Pediatric Upper Extremity: Diagnosis and Management","first-page":"247","article-title":"Injuries to the brachial plexus","author":"Narakas","year":"1986"},{"key":"b26-peds15543","series-title":"The Paralysed Hand","first-page":"116","article-title":"Obstetrical brachial plexus injuries","volume":"2","author":"Narakas","year":"1987"},{"key":"b27-peds15543","series-title":"Arch Gynecol Obstet","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s00404-012-2272-z","article-title":"Risk factors for neonatal brachial plexus paralysis","volume":"286","author":"Okby","year":"2012"},{"key":"b28-peds15543","series-title":"Semin Perinatol","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1053\/j.semperi.2014.04.008","article-title":"Risk factors for neonatal brachial plexus palsy","volume":"38","author":"Ouzounian","year":"2014"},{"key":"b29-peds15543","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1227\/01.NEU.0000170557.13788.D2","article-title":"External rotation as a result of suprascapular nerve neurotization in obstetric brachial plexus lesions","volume":"57","author":"Pondaag","year":"2005"},{"issue":"1 Suppl","key":"b30-peds15543","series-title":"J Neurosurg","first-page":"33","article-title":"Recovery of hand function following nerve grafting and transfer in obstetric brachial plexus lesions","volume":"105","author":"Pondaag","year":"2006"},{"key":"b31-peds15543","series-title":"Dev Med Child Neurol","first-page":"138","article-title":"Natural history of obstetric brachial plexus palsy: a systematic review","volume":"46","author":"Pondaag","year":"2004"},{"key":"b32-peds15543","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.3174\/ajnr.A3820","article-title":"High-resolution MRI evaluation of neonatal brachial plexus palsy: A promising alternative to traditional CT myelography","volume":"35","author":"Somashekar","year":"2014"},{"key":"b33-peds15543","series-title":"J Hand Surg Am","doi-asserted-by":"publisher","first-page":"2387","DOI":"10.1016\/j.jhsa.2013.09.006","article-title":"Understanding quality of life and patient expectations among adolescents with neonatal brachial plexus palsy: a qualitative and quantitative pilot study","volume":"38","author":"Squitieri","year":"2013"},{"key":"b34-peds15543","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1097\/PRS.0b013e3181f95c1e","article-title":"A national study to evaluate trends in the utilization of nerve reconstruction for treatment of neonatal brachial plexus palsy","volume":"127","author":"Squitieri","year":"2011"},{"key":"b35-peds15543","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.3174\/ajnr.A3878","article-title":"The diagnostic value of CT myelography, MR myelography, and both in neonatal brachial plexus palsy","volume":"35","author":"Tse","year":"2014"},{"key":"b36-peds15543","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1007\/s003810000319","article-title":"Management of obstetric brachial plexus lesions: state of the art and future developments","volume":"16","author":"van Ouwerkerk","year":"2000"},{"key":"b37-peds15543","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"283","DOI":"10.3171\/2011.12.PEDS11416","article-title":"Utility of electrodiagnostic testing and computed tomography myelography in the preoperative evaluation of neonatal brachial plexus palsy","volume":"9","author":"Vanderhave","year":"2012"},{"key":"b38-peds15543","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"649","DOI":"10.2106\/00004623-199905000-00006","article-title":"Comparison of the natural history, the outcome of microsurgical repair, and the outcome of operative reconstruction in brachial plexus birth palsy","volume":"81","author":"Waters","year":"1999"},{"key":"b39-peds15543","series-title":"J Am Acad Orthop Surg","doi-asserted-by":"publisher","first-page":"205","DOI":"10.5435\/00124635-199707000-00004","article-title":"Obstetric brachial plexus injuries: evaluation and management","volume":"5","author":"Waters","year":"1997"},{"key":"b40-peds15543","series-title":"BJOG","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1111\/j.1471-0528.2007.01392.x","article-title":"Labour characteristics and neonatal Erb's palsy","volume":"114","author":"Weizsaecker","year":"2007"},{"key":"b41-peds15543","series-title":"Semin Perinatol","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1053\/j.semperi.2014.04.009","article-title":"Neonatal brachial plexus palsy\u2014management and prognostic factors","volume":"38","author":"Yang","year":"2014"},{"key":"b42-peds15543","series-title":"J Hand Surg Am","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1016\/j.jhsa.2015.01.039","article-title":"The prognostic value of concurrent phrenic nerve palsy in newborn babies with neonatal brachial plexus palsy","volume":"40","author":"Yoshida","year":"2015"},{"key":"b43-peds15543","series-title":"J Perinatol","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1038\/jp.2014.215","article-title":"Are there modifiable risk factors that may predict the occurrence of brachial plexus injury?","volume":"35","author":"Zuarez-Easton","year":"2015"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/17\/5\/article-p618.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/17\/5\/article-p618.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/17\/5\/article-p618.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T13:23:21Z","timestamp":1681565001000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/17\/5\/article-p618.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5]]},"references-count":43,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2015.10.peds15543","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5]]}}}