Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores.
BACKGROUND
Preterm infants are at 8 times higher risk than term infants for pre- and perinatal brain damage, resulting in cerebral palsy. In this paper we have analysed the influence of prenatal and birth-related risk factors on cerebral palsy in preterm infants.


METHODS
In a register-based study, 175 preterm singleton infants with cerebral palsy, born in 1982-86, were compared with 687 controls matched by gestational age and year of birth.


RESULTS
Statistically significant higher rates in cases were found in parity > or = 3 (22% vs. 16%, p < 0.05), Cesarean section (67% vs. 56%, p < 0.01), and low Apgar scores at 1 minute (45% vs. 36%, p < 0.05). By multivariate analyses, two variables remained statistically significant: parity > or = 3 (adjusted OR = 1.53 (95% CI 1.00-2.34), p < 0.05) and Cesarean section (adjusted OR = 1.57 (95% CI 1.07-2.32), p < 0.05).


CONCLUSIONS
Pregnancy complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited.
Topp
M
M
Department of Obstetrics and Gynecology, University of Copenhagen, Hvidovre Hospital, Denmark.
Langhoff-Roos
J
J
Uldall
P
P
D000328:Adult; D000704:Analysis of Variance; D001034:Apgar Score; D002547:Cerebral Palsy / Q000209:etiology*; D002585:Cesarean Section / Q000009:adverse effects; D003718:Denmark; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors