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Cerebral palsy among term and postterm births.
Dag Moster1, Allen J Wilcox, Stein Emil Vollset
1Department of Public Health and Primary Health Care, University of Bergen, PO Box 7804, N-5020 Bergen, Norway. Dag.Moster@smis.uib.no
JAMA
|September 3, 2010
Summary
Delivery timing impacts cerebral palsy (CP) risk. Birth at 40 weeks gestation has the lowest CP risk, while earlier or later deliveries increase the risk for infants. This highlights the importance of optimal gestational age for infant neurodevelopment.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Public Health Epidemiology
Background:
- Preterm delivery is a known risk factor for cerebral palsy (CP), but most CP cases occur in term infants.
- Limited data exists on CP risk related to gestational age within the term and postterm periods.
Purpose of the Study:
- To investigate the association between the timing of birth (term and postterm) and the risk of developing cerebral palsy (CP).
Main Methods:
- A population-based follow-up study utilized the Medical Birth Registry of Norway.
- Included 1,682,441 singleton infants born between 37 and 44 weeks gestation (1967-2001), excluding congenital anomalies.
- Follow-up through national registries until 2005 to assess CP risk in children surviving to at least 4 years.
Main Results:
- Infants born at 40 weeks gestation had the lowest CP prevalence (0.99/1000).
- Delivery at 37 weeks (RR 1.9) and 38 weeks (RR 1.3) showed increased CP risk compared to 40 weeks.
- Postterm delivery at 42 weeks (RR 1.4) and beyond (RR 1.4) also elevated CP risk.
- Associations were stronger when gestational age was determined by ultrasound.
Conclusions:
- Delivery at 37, 38, 42 weeks, or later gestation is associated with a higher risk of cerebral palsy (CP) compared to delivery at 40 weeks.
- Gestational age at birth is a critical factor in determining CP risk for term and postterm infants.
- Findings underscore the importance of optimizing delivery timing to mitigate CP risk.
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