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Adverse motor outcome after paediatric ischaemic stroke: A nationwide cohort study

Katarina Svensson1,2, Anna Walås1,2, Jenny Bolk3,4,5

  • 1Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Paediatric and Perinatal Epidemiology
|February 16, 2022
PubMed

Insights

Paediatric ischaemic stroke significantly increases the risk of adverse motor outcomes, such as cerebral palsy. This nationwide study highlights a substantial risk, particularly in childhood stroke cases, with no identified links to sex or gestational age.

Area of Science:

  • Neurology
  • Pediatrics
  • Epidemiology

Background:

  • Adverse motor outcomes, including cerebral palsy and hemiplegia, are known complications of paediatric ischaemic stroke.
  • Limited data exists on the nationwide incidence and risk factors for these outcomes in paediatric stroke populations.

Purpose of the Study:

  • To determine the risk of adverse motor outcomes following paediatric ischaemic stroke within a nationwide cohort.
  • To identify potential contributing risk factors for these adverse motor outcomes.

Main Methods:

  • A nationwide matched cohort study was conducted using Swedish health registers (1997-2016).
  • 877 children under 18 with ischaemic stroke were matched with 10 unexposed children.
  • Cox and logistic regression models were used to analyze the risk and characteristics of adverse motor outcomes.

Main Results:

  • Children with ischaemic stroke had a significantly higher risk of adverse motor outcomes (31.9%) compared to unexposed children (0.2%), with an adjusted hazard ratio of 167.78.
  • Risk estimates did not differ significantly between perinatal and childhood stroke.
  • Childhood stroke showed an association with adverse motor outcome (aOR 1.56), while sex, gestational age, and parental age at birth were not associated.

Conclusions:

  • Paediatric ischaemic stroke carries a substantial risk of adverse motor outcomes, particularly in cases of childhood stroke.
  • Previous findings on the high risk are confirmed, but this study found no association with sex, gestational age, or parental age at birth.
Abstract

Keywords:
adverse motor outcomecerebral palsychildrencohort studieshemiplegiaischaemic stroke

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