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ORIGINAL RESEARCH article

Front. Pediatr.

Sec. Neonatology

Volume 13 - 2025 | doi: 10.3389/fped.2025.1648252

Neonatal Birth Trauma: Identifying New Risk Factors and Short-Term Outcomes

Provisionally accepted
Nirzar  Samir ParikhNirzar Samir Parikh1,2*Collins  OdhiamboCollins Odhiambo2Holleigh  McmastersHolleigh Mcmasters1,2Grace  Kathryn BorkowskiGrace Kathryn Borkowski3Adam  CrossAdam Cross1,2Gretchen  KopecGretchen Kopec1,2
  • 1Pediatrics, OSF HealthCare, Peoria, United States
  • 2Pediatrics, University of Illinois College of Medicine-Peoria, Peoria, United States
  • 3University of Illinois College of Medicine-Peoria, Peoria, United States

The final, formatted version of the article will be published soon.

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 p > 0.05). Significant differences were observed in maternal age (p = 0.042), gravidity (p = 0.04), and parity (p = 0.002), with affected mothers being younger, with fewer pregnancies and lower parity. Mothers with chronic or gestational hypertension, with or without preeclampsia, had higher odds of neonatal birth trauma (OR = 1.582, 95% CI: 1.081–2.316, p = 0.018). Emergent deliveries nearly tripled the odds (OR = 2.8, 95% CI: 1.934–4.054, p < 0.001). Neonates exposed to maternal epidural anesthesia were more likely to suffer from birth trauma (77.5 vs. 51.7%, p < 0.001) 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.

Keywords: neonates, Birth trauma, social determinants of health, Risk factors, outcomes

Received: 16 Jun 2025; Accepted: 11 Sep 2025.

Copyright: © 2025 Parikh, Odhiambo, Mcmasters, Borkowski, Cross and Kopec. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Nirzar Samir Parikh, parikhnirzar@gmail.com

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