The role of perinatal and intrapartum risk factors in the etiology of cerebral palsy in term deliveries in a Turkish population.
OBJECTIVE
To investigate the relationship between cerebral palsy (CP) and perinatal and intrapartum risk factors and markers of birth asphyxia.


METHODS
This was a retrospective case-control study of 101 children with CP and 308 controls who were born at the Zeynep Kamil Hospital between 1990 and 2000. The roles of possible perinatal and intrapartum risk factors were investigated in CP development. Chi-square tests, Fisher's exact tests, Student t-tests, and regression analysis were used for statistical analysis (p < 0.05).


RESULTS
The only significant perinatal risk factor was neonatal weight of <2500 grams. The CP rate in the presence of solely intrapartum risk factors was estimated as 24.7% (n = 25). In 39.6% of cases, no risk factor could be identified. When regression analysis was performed, the following factors were significant: decreased beat-to-beat variability on electronic fetal monitoring (EFM) (p = 0.02), an Apgar score of <7 at 1 and 5 minutes (p = 0.02), and the necessity for neonatal intensive care unit admission (p < 0.0001).


CONCLUSIONS
Intrapartum risk factors were significantly more frequent in the CP group (p < 0.01). An increased cesarean section rate could not prevent CP, suggesting that the hypoxic insult that causes CP might be of chronic onset. The development of diagnostic tests to detect non-reassuring fetal status in its intrauterine life and interventions at appropriate times may decrease the CP rate.
Gurbuz
Ayse
A
Zeynep Kamil Women's and Children's Diseases Education and Research Hospital, Istanbul, Turkey. canankabaca@yahoo.com
Karateke
Ates
A
Yilmaz
Ufuk
U
Kabaca
Canan
C
D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000150:complications; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000209:etiology* / Q000503:physiopathology; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005315:Fetal Diseases / Q000209:etiology* / Q000503:physiopathology; D005311:Fetal Hypoxia / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D007744:Obstetric Labor Complications / Q000209:etiology / Q000503:physiopathology; D011247:Pregnancy; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey