Seyed Amir Ghadiri Asli - Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
Parsa Monajemi - Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Enayatollah Homaie Rad - Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
Morteza Rahbar Taramsari - Department of Forensic Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Zahra Pour Habibi - Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
Kourosh Delpasand - Department of Medical Ethics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

Introduction:Erb Duchenne paralysis is the most common form of neonatal brachial plexus palsy. Cesareansection is one of the protective factors in Erb paralysis.Materials and Methods: The data were related to mothers who gave birth by both natural and cesarean sectionduring the study period in Al Zahra Hospital in Rasht, as well as their infants . T he number of cases of Erbparalysis during one month periods was identified and for the mentioned period, the interrupted time seriesanalysis or ITSA method was calculated and its changes were measured. Other variables including maternalage at delivery, weight of newb orns at birth and total number of deliveries by delivery method were extractedand recorded from the maternity and neonatal registry.Results:In this study, ۷ cases of neonatal paralysis were recorded, which indicates an incidence of ۰.۱۷ casesper ۱۰۰۰ births, of which ۶ cases were registered after the implementation of the Health Transformation Plan.Considering the confounding variables, the number of cases of Erb paralysis during the period after theimplementation of the he alth system transformation plan has an upward trend compared to before itsimplementation, which according to P = ۰.۰۷۹, this difference with a ۹۰% confidence interval is significant.have been. Also, deliveries performed by cesarean section have increased from ۶۰.۱% before thetransformation plan to ۶۴.۱% after the transformation plan.Conclusion:This study showe d that the incidence of Erb paralysis in Al Zahra Center is lower than otherincidence in other studies in other coun tries. Also, due to its higher incidence in normal deliveries, in additionto reducing the rate of cesarean section to maintain the health of mother and baby, special attention should bepaid to increasing the likelihood of some complications following a n ormal delivery.

Erb paralysis, Health system transformation plan, Cesarean section, Natural childbirth