Cerebral palsy among children born during the Dublin randomised trial of intrapartum monitoring.
In a randomised trial involving 13,079 liveborn children intrapartum care by electronic fetal heart rate monitoring, with scalp blood sampling when indicated, was associated with a 55% reduction in neonatal seizures. Reassessment, when aged 4, of the 9 children in the intensively monitored group and 21 in the control group who survived after neonatal seizures showed that 3 such children in each group had cerebral palsy. A fourth child in the intensively monitored group with cerebral palsy had had transient abnormal neurological signs during the neonatal period. 8 other children in the intensively monitored group and 7 in the control group who had not had abnormal neurological signs in the neonatal period also had cerebral palsy. 16 (78%) of the total of 22 cases of cerebral palsy had not shown clinical signs suggestive of intrapartum asphyxia. Thus, compared with intermittent intrapartum monitoring, intensive monitoring has little, if any, protective effect against cerebral palsy.
Grant
A
A
National Perinatal Epidemiology Unit, Radcliffe Infirmary, Oxford.
O'Brien
N
N
Joy
M T
MT
Hennessy
E
E
MacDonald
D
D
D001238:Asphyxia Neonatorum / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D002547:Cerebral Palsy / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002675:Child, Preschool; D036861:Delivery, Obstetric / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D005500:Follow-Up Studies; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D007494:Ireland / Q000453:epidemiology; D008297:Male; D009460:Neurologic Examination; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors