Prevalence of newborn brachial plexus palsy in Accra, Ghana.

Abstract

The aim of this study was to provide hospital-based epidemiological information about newborn brachial plexus palsy (NBPP) in Accra, Ghana. The records of all pediatric patients treated over a 5-year period (December 1999 and December 2004) were retrieved to identify those with NBPP. The records of those who had NBPP were further reviewed to document their sociodemography, diagnosis, labor and birth history, presentation at birth, mode and place of delivery. A total of 773 patients' records were reviewed out of which 210 (27.2%) were cases of NBPP. Using the 1987 Narakas system of classification, majority (94.8%) of the NBPP cases were of group∼I type brachial plexus injury or Erb's palsy, with a male predominance (61.4%), and most (79.5%) were delivered by normal vaginal delivery (52.9%) and most (70.9%) were cephalic in presentation at birth. About 55.2% cases were referred for physiotherapy within one month of diagnosis. The treatment disposition for majority (88.1%) of the NBPP patients was not documented and only (4.8%) was formally discharged from physiotherapy. The results indicate that birth weight exceeding 4.0 kg, vertex presentation and vaginal delivery were the noticeable co-existing factors for NBPP in this population. The Erb's type was the modal type of NBPP in the sample and majority were delivered in private clinics. The clinical, economic and sociocultural implications of this disorder, as well as the importance of better clinical documentation in physiotherapy and needs for a national survey for NBPP in Ghana was discussed.