ABSTRACT
The objective of this study is to identify maternal, perinatal, and fetal risk factors
for clavicular fracture in a single institution. We performed a prospective study
of all deliveries during a 14-month period to identify confirmed cases of neonatal
clavicular fracture. The control group consisted of the deliveries immediately preceding
and following the index cases. Fifty-three cases of clavicular fracture were identified
among the 4789 deliveries from October 1995 through November 1996 for an incidence
of 1.11%. Three neonates in the clavicular fracture group were delivered through cesarean
section. Neonates with fracture were significantly heavier at birth than those without
(3564 vs. 3283 g, p <0.001), and had a lower mean head-to-abdominal circumference ratio (0.93 vs. 1.08,
p <0.001), history of giving birth to a macrosomia (21 vs. 4%, p <0.05). The anterior shoulder was the predominant site of fracture (30/53). Fracture
was detected mostly during the first 3 days of neonatal life (46/53). The outcome
was benign, with complete recovery in all cases and no associated neurological sequelae.
Neonatal clavicular fracture tended to be associated with neonatal somatometric characteristics
and difficult deliveries. Considering the benign nature of this birth trauma, more
invasive intrapartum management to lower its incidence is not advised.
KEYWORD
Neonatal - clavicular fracture - incidence - predisposing factors
