Which statement best reflects the cause of neonatal spinal injury?

• A. Intrauterine infection is the most frequent cause
• B. Difficult delivery is the most frequent cause
• C. Postnatal trauma is the most frequent cause
• D. Genetic predisposition is the most frequent cause

Answer: (B)

Neonatal spinal injuries are most often the result of birth trauma during labor and delivery. When delivery is difficult—such as with challenging head or shoulder passage, breech presentation, or the need for instrument-assisted delivery—the neck and spine can be subjected to traction, rotation, or compression. This mechanical stress during the birth process can injure the cervical spine or spinal cord. Intrauterine infection can cause other neonatal problems but is not the frequent cause of spinal injury. Postnatal trauma in a newborn is relatively rare, and genetic predisposition doesn’t typically explain most spinal injuries in this age group. The essential idea is that the birth process itself, especially a difficult delivery, is the primary mechanism behind neonatal spinal injuries.