Newborn Birth Injuries

Abstract

A newborn may occasionally endure physical injury during the process of labor, delivery, or after delivery, involving different superficial and deep tissues, resulting in structural and/or functional impairment. There has been a significant decrease in the incidence of birth-related injuries over the last several decades due to the increasing use of cesarean delivery instead of performing difficult vaginal deliveries. While most birth injuries are temporary and self-limiting with full recovery, some may be lifelong, resulting in significant morbidity and mortality. Birth trauma may also occasionally occur during an uncomplicated delivery without documented risk factors in utero, before the initiation of the birth process or during a cesarean birth, making its occurrence often unpredictable and unavoidable. Despite skilled and competent obstetric care and reduction in related mortality rates, birth injuries still represent an important source of neonatal morbidity and neonatal intensive care unit admissions. To minimize potential complications and to improve outcomes following birth trauma, it is essential for the clinician to fully and promptly evaluate all newborns for evidence of trauma. While all newborns need this careful evaluation, there should be special consideration of babies delivered by forceps and/or vacuum, breech or other abnormal presentations, large babies, and babies born through precipitous labor. In addition to early diagnosis and prompt appropriate management, documentation prior to hospital discharge will help avoid inappropriate suspicion of inflicted injury (child abuse) at a later date.