Neonatal birth trauma: identifying new risk factors and short-term outcomes.

Background: Advancements in prenatal diagnosis and obstetric care have changed the epidemiology of neonatal birth trauma in developed countries. Improving women's access to health care is key to preventing, detecting, and treating conditions that increase pregnancy complications and adverse neonatal outcomes. Objective: To identify new risk factors-focusing on social determinants of health-and short-term outcomes associated with neonatal birth trauma. Study design: Term neonates with unexpected complications born between January 1, 2019, and March 31, 2023, at 10 diverse hospitals in our health system were identified using Perinatal Care-06 coding. Maternal and neonatal charts were reviewed and recorded in REDCap. Neonates with and without birth trauma were assigned to case and control groups, respectively. Risk factors were identified using Pearson chi-square tests and multivariable logistic regression. Results: Of 711 neonates, 187 (26.3%) experienced birth trauma, primarily scalp injuries (Caput Succedaneum 42%, Ecchymosis/Bruising 27%). There were no significant differences in race, language barriers, insurance type, marital status, prenatal care access, mean household income (zip code), gestational age, maternal height, birth weight, or head circumference (all Conclusion: Social determinants and prenatal care access did not significantly impact birth trauma. However, hypertension, exposure to epidural anesthesia and emergent delivery were associated with an increased risk.