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Published on: November 20, 2015
Risk factors associated with cerebral palsy in preterm infants
Andrea Sukhov1, Yvonne Wu, Guibo Xing
1Department of Obstetrics and Gynecology, University of California, Sacramento, CA 95817, USA.
Insights
Prematurity significantly increases the risk of cerebral palsy (CP) in infants. Other factors like birth asphyxia and defects also contribute to CP development, indicating a multifactorial cause.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Neurology
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder.
- Understanding risk factors for CP, particularly in preterm infants, is crucial for prevention and intervention.
Purpose of the Study:
- To investigate the relationship between pregnancy outcomes and the development of cerebral palsy (CP) in preterm infants.
- To identify specific pregnancy and delivery complications associated with CP in this population.
Main Methods:
- Retrospective population-based cohort study using California state databases (1991-2001).
- Identified children with CP and compared them to controls without CP.
- Analyzed demographic data and pregnancy outcomes, stratified by gestational age and controlling for confounders.
Main Results:
- Prematurity, especially delivery before 28 weeks gestation, was strongly associated with CP (OR 18.2).
- Birth asphyxia (OR 5.9), birth defects (OR 4.3), cord prolapse (OR 2.0), and fetal distress (OR 2.1) were also significant risk factors for CP.
- The impact of these factors varied, with prematurity having the largest effect.
Conclusions:
- Prematurity is the most significant factor influencing CP development in preterm infants.
- CP in preterm infants likely results from a multifactorial etiology, including prematurity, birth asphyxia, birth defects, and adverse labor events.
- These findings highlight the need for comprehensive management of high-risk pregnancies and deliveries.
Objective:
To examine pregnancy outcomes in preterm delivered children with cerebral palsy (CP).
Methods:
A retrospective population-based cohort study of children born in California (January 1, 1991 and December 31, 2001) with CP were identified (State databases) and compared to children without CP. We examined demographic data and pregnancy outcomes by gestational age groups controlling for multiple co-founders.
Results:
Of 2733 preterm infants (total of 8397, 33% <37 weeks of gestation) with CP, delivery <28 weeks had the largest impact upon the development of CP (Odds ratio (OR) 18.2 95%CI (16.7, 19.9)) with delivery 28-31 6/7 weeks having less impact (OR 8.8 (8.0, 9.7) when compared to term deliveries. Birth asphyxia (OR 5.9 (5.3, 6.6) was associated with the future development of CP as were birth defects (OR 4.3 (4.1. 4.5), cord prolapse (OR 2.0 (1.6, 2.4)) and fetal distress (OR 2.1 (1.9, 2.2)) the latter 2 being less so.
Conclusion:
Prematurity had the greatest impact upon the future development of CP; however, birth asphyxia, birth defects and adverse labor events contributed significantly to the future development of CP as well, suggesting that the cause of CP in the preterm infant is most likely multifactorial.
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