Birth Injuries and Associated Risk Factors: A Multicenter Study Publisher



Mosayebi Z ; Dashtkoohi M ; Shariat M ; Moeini R ; Moeinafshar A ; Zarkesh M R ; Naddaf A ; Mehri S ; Sinaeifar Z
Source: Innovative Journal of Pediatrics Published:2026

Abstract

Background: Neonatal birth trauma, encompassing a broad spectrum of injuries, occurs during delivery and remains a significant concern in perinatal care. Objectives: This study aimed to identify different types of birth trauma and examine the risk factors associated with their occurrence, with particular emphasis on the Iranian population, in which these factors are not well known. Methods: This case-control study was conducted at three referral hospitals from April 2019 to March 2020. Data were collected from neonatal medical records. Potential risk factors, including maternal and perinatal characteristics, were compared between two groups of newborns according to the presence or absence of birth trauma. The case group comprised neonates with birth trauma, whereas the control group included neonates without birth trauma. Logistic regression was used to assess the associations between risk factors and birth trauma. Results: The overall incidence of birth trauma was 8.77 per 1,000 live births. This study investigated risk factors for birth trauma in 129 neonates, including 43 neonates with trauma and 86 healthy neonates. Head and neck injuries were the most common (65.1%), followed by bone fractures (18.6%) and brachial plexus injuries (9.3%). Multivariate logistic regression analysis showed that a diploma literacy level or higher (B = -0.659, P = 0.020) and cesarean delivery (B = -2.795, P < 0.001) were protective factors against birth trauma, whereas the need for birth resuscitation (B = 2.695, P = 0.002) was significantly associated with higher odds of birth trauma. Maternal age, hypertension, diabetes, and presentation type were not significantly associated with birth trauma in this population. Conclusions: Maternal educational level and delivery type are reliable predictors of birth trauma occurrence. Identifying the risk factors associated with birth injuries is essential for improving perinatal care and minimizing adverse outcomes. Copyright © 2026, Mosayebi et al.