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Antecedents of cerebral palsy and perinatal death in term and late preterm singletons

The odds of total cerebral palsy after potentially asphyxial birth events or inflammation were modestly increased.

Authors:
McIntyre S, Blair E, Badawi N, Keogh J, Nelson KB

Authors notes:
Obstetrics & Gynecology. 2013;122(4):869-877

Keywords:
Cerebral palsy, perinatal death, asphyxial birth events, inflammation

Abstract:
To examine the antecedents of cerebral palsy and of perinatal death in singletons born at or after 35 weeks of gestation.

The odds of total cerebral palsy after potentially asphyxial birth events or inflammation were modestly increased.

However, potentially asphyxial birth events occurred in 34% of intrapartum stillbirths and 21.6% of cerebral palsy after hypoxic-ischemic encephalopathy.

Inflammatory markers occurred in 13.9% and 11.9% of these outcomes, respectively.

Growth restriction contributed significantly to all poor outcome groups.

Birth defects were recognized in 5.5% of neonates in the control group compared with 60% of neonatal deaths and more than half of cases of cerebral palsy without hypoxic-ischemic encephalopathy.

In children with cerebral palsy, a potentially asphyxial birth event, inflammation, or both were experienced by 12.6%, whereas growth restriction, a birth defect, or both were experienced by 48.6%.

Fetal growth restriction and birth defects recognized by age 6 years were more substantial contributors to cerebral palsy and neonatal death than potentially asphyxial birth events and inflammation.