Newborn Birth Injuries

  • Smeeta SardesaiEmail author


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.


Caput Cephalohematoma Subgaleal Fracture Injuries Palsy Brachial Newborn Baby 


  1. 1.
    Lyons J, Pressey T, Bartholomew S, Liu S, Liston RM, Joseph KS. Canadian perinatal surveillance system (Public Health Agency of Canada). Delivery of breech presentation at term gestation in Canada, 2003–2011. Obstet Gynecol. 2015;125(5):1153–61.CrossRefPubMedGoogle Scholar
  2. 2.
    Demissie K, Rhoads GG, Smulian JC, et al. Operative vaginal delivery and neonatal and infant adverse outcomes: population based retrospective analysis. BMJ. 2004;329(7456):24–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Benaron DA. Subgaleal hematoma causing hypovolemic shock during delivery after failed vacuum extraction: a case report. J Perinatol. 1993;13:228.PubMedGoogle Scholar
  4. 4.
    Rosenberg AA. Traumatic birth injury. NeoReviews. 2003;4(10):e270–6.CrossRefGoogle Scholar
  5. 5.
    Miedema CJ, et al. Primarily infected cephalhematoma and osteomyelitis in a newborn. Eur J Med Res. 1999;4:8.PubMedGoogle Scholar
  6. 6.
    Akangire G, Carter B. Birth Injuries in Neonates. Pediatr Rev 2016;37(11):451–462.CrossRefPubMedGoogle Scholar
  7. 7.
    Mangurten HH, Puppala BL. Birth injuries. In: Fanaroff AA, Martin RJ, Walsh MC, editors. Fanaroff and Martin’s neonatal-perinatal medicine, vol. 1. 10th ed. Philadelphia: Elsevier/Saunders; 2015. p. 407–35.Google Scholar
  8. 8.
    Tanzi EL, Hornung RL, Silverberg NB. Halo scalp ring. A case series and review of the literature. Arch Pediatr Adolesc Med. 2002;156(2):188–90. Scholar
  9. 9.
    Wong CH, Foo CL, Seow WT. Calcified cephalohematoma: classification, indications for surgery and techniques. J Craniofac Surg. 2006;17(5):970–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Uhing MR. Management of birth injuries. Clin Perinatol. 2005;32(1):19–38.CrossRefPubMedGoogle Scholar
  11. 11.
    Dupuis O, Silveira R, Dupont C, et al. Comparison of “instrument-associated” and “spontaneous” obstetric depressed skull fractures in a cohort of 68 neonates. Am J Obstet Gynecol. 2005;192(1):165–70.CrossRefPubMedGoogle Scholar
  12. 12.
    Djientcheu VP, Njamnshi AK, Ongolo-Zolo P, Kobela M, Rilliet B, Essomba A, Sosso MA. Growing skull fractures. Childs Nerv Syst. 2006;22:721–5.CrossRefGoogle Scholar
  13. 13.
    Volpe KA, Snowden JM, Cheng YW3, Caughey AB. Risk factors for brachial plexus injury in a large cohort with shoulder dystocia. Arch Gynecol Obstet. 2016;294(5):925–9. Epub 2016 Apr 4.CrossRefPubMedGoogle Scholar
  14. 14.
    Otto Heise C, et al. Neonatal brachial plexus palsy. Arq Neuropsiquiatr. 2015;73(9):803–8.CrossRefGoogle Scholar
  15. 15.
    Murty VSSY, Ram KD. Phrenic nerve palsy: a rare cause of respiratory distress in newborn. J Pediatr Neurosci. 2012;7(3):225–7. Scholar
  16. 16.
    Yang LJ. Neonatal brachial plexus palsy – management and prognostic factors. Semin Perinatol. 2014;38(4):222–34.CrossRefPubMedGoogle Scholar
  17. 17.
    Mahé E, Girszyn N, Hadj-Rabia S, Bodemer C, Hamel-Teillac D, De Prost Y. Subcutaneous fat necrosis of the newborn: a systematic evaluation of risk factors, clinical manifestations, complications and outcome of 16 children. Br J Dermatol. 2007;156(4):709–15.CrossRefPubMedGoogle Scholar
  18. 18.
    Shumer DE, Thaker V, Taylor GA, Wassner AJ. Severe hypercalcaemia due to subcutaneous fat necrosis: presentation, management and complications. Arch Dis Child Fetal Neonatal Ed. 2014;99(5):F419–21.CrossRefPubMedGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA

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