Does nuchal cord at birth increase the risk for cerebral palsy?

Nuchal cord is a common finding in pregnancy. It is unclear whether a nuchal cord at birth causes birth asphyxia and raises the risk for developing cerebral palsy of the offspring.

To evaluate the incidence of cerebral palsy in children born with and without nuchal cord.

A population-based cohort analysis including all singleton deliveries over >20 years at a single tertiary medical center was conducted. The incidence of cerebral palsy in children up to 18 years of age was evaluated. Kaplan-Meier survival curve was used to compare cumulative incidence between the groups, and a Cox proportional hazards model was used to control for confounders.

During the study period, 243,682 singleton deliveries met the inclusion criteria. Of them, 14.1% (n = 34,332) were diagnosed with nuchal cord at birth. Rates of cerebral palsy were comparable between the groups (0.1% vs. 0.1%, OR = 1.03, 95% CI 0.69-1.52, p = 0.89). The Kaplan-Meier survival curve demonstrated no significant differences in cumulative incidence of cerebral palsy for children born with or without nuchal cord (log rank p = 0.92, Fig. 1). The Cox proportional hazards model, controlled for preterm delivery, maternal age, diabetes and hypertensive disorders, showed no association between nuchal cord and cerebral palsy (adjusted HR = 1.06; 95% CI 0.71-1.57; p = 0.77).

In our population, nuchal cord at birth was not associated with higher risk for cerebral palsy.