THE EFFECTS OF GESTATIONAL DIABETES AND INFANT SEX ON THE INCIDENCE OF BRACHIAL PLEXUS INJURY

Elhadi Araibi, Fatma Alashkham, Altayeb Elazomi*, Abd Alla A. Mohamed, Taher M. Abdelhameed, Heba Abdulrahman and Reem Eshibani

ABSTRACT

The brachial plexus is a bundle of nerves that carry signals from the spinal cord to the shoulder, arm, hand, and fingers. Brachial plexus birth palsy (BPBP) primarily involving the C5-C6 (the upper trunk) and sometimes the C7 (the middle trunk) of the brachial plexus. Studies have shown that several risk factors including fetal, maternal, and labor factors are responsible for the incidence of brachial plexus injury. The aim of the study was to assess the effect of maternal factor of gestational diabetes and the fetal factor of infant gender on the incidence of brachial plexus injury. 170 patients were admitted to physiotherapeutic center of Abogalasha in the city of Zawia, Libya between July 2012 and July 2017. From the clinic records, information including the maternal age, number of deliveries, incidence of gestational diabetes, birth weight, degree of macrosomia, degree and location of brachial plexus injury were collected and statistically analyzed. Results: Among 170 patients, the most frequent indication for admission of infants to the physiotherapeutic center was Erb's palsy in 124 patients (72.94%), followed by muscle atrophy in 27 patients (15.88%), and hypoesthesia in 19 patients (11.18%). Among 124 cases with Erb's palsy, 108 patients (87.1%) were born to mothers with gestational diabetes mellitus (GDM). Out of 108 patients, 74 patients (59.68%) were males, and 34 patients (27.42%) were females. There were 16 patients with Erb’s palsy (13%) born to non-gestational diabetic mothers. Of these babies, 9 patients (7.26%) were males, and 7 patients (5.65%) were females. The type of delivery was vaginal delivery in most of patients. The incidence of Erb’s palsy is a multifactorial in which both maternal factor of gestational diabetes and fetal factor of male gender are affecting the incidence of the disorder than any of these factors alone. Therefore, gestational diabetes mellitus and male gender both would be indicators for C/S to avoid the incidence of Erb's palsy.

Keywords: Erb’s palsy, Gestational diabetes mellitus, Infant gender.