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Risk of cerebral palsy by gestational age among pregnancies at-risk for preterm birth

Devin D Smith1, Deepika Sagaram1, Russell Miller1

  • 1Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY, USA.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|October 16, 2018
PubMed

Insights

Cerebral palsy (CP) risk decreases with increased gestational age (GA) in high-risk pregnancies. Magnesium and antibiotic exposure were protective factors, especially before 28 weeks GA.

Area of Science:

  • Perinatology
  • Neonatology
  • Neurology

Background:

  • Cerebral palsy (CP) is a significant concern in preterm infants.
  • Understanding CP incidence in spontaneous preterm birth (sPTB) populations is crucial for targeted interventions.

Purpose of the Study:

  • To determine cerebral palsy (CP) incidence stratified by gestational age (GA) groups.
  • To identify risk and protective factors for CP in pregnancies at risk for spontaneous preterm birth (sPTB).

Main Methods:

  • Secondary analysis of a randomized controlled trial on magnesium for neuroprotection.
  • Included nonanomalous singleton gestations with preterm premature rupture of membranes (PPROM) or preterm labor (PTL).
  • Logistic regression used to adjust for confounders, stratifying CP incidence by GA groups.

Main Results:

  • CP affected 4.3% of 1747 pregnancies.
  • Increasing GA was associated with lower CP rates (RR 0.96).
  • Magnesium and antibiotic exposure were significant protective factors (aRR 0.52 for both), with magnesium's effect most pronounced before 28 weeks GA.

Conclusions:

  • CP risk in high-risk sPTB populations decreases with advancing GA.
  • While risk is highest before 34 weeks, it persists thereafter.
  • Magnesium administration shows significant neuroprotective effects, particularly in extremely preterm infants.

Keywords:
Cerebral palsygestational agegroupmagnesiumpreterm birth

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