title: Risk factors for perinatal arterial ischaemic stroke in full-term infants: a case-control study.
abstract: OBJECTIVE
  The incidence of perinatal arterial ischaemic stroke (PAIS) is about 1 in 2300 live births. Evidence about the aetiology is still lacking. The aim of this study was to identify maternal, perinatal and neonatal risk factors for symptomatic PAIS in full-term infants.
  
  
  METHODS
  Each full-term infant with PAIS was matched to three healthy controls for gestational age, date of birth and hospital of birth. Antenatal and perinatal risk factors were studied using univariate and multivariate conditional logistic regression analysis.
  
  
  RESULTS
  Fifty-two infants were diagnosed with PAIS. Significant risk factors in the univariate analysis (p<0.05) were nulliparity (64% vs 47%), maternal fever (>38°C) during delivery (10% vs 1%), fetal heart rate decelerations (63% vs 16%), meconium-stained amniotic fluid (44% vs 17%), emergency caesarean section (35 vs 2%), Apgar score (1 min) ≤3 (29% vs 1%), Apgar score (5 min) <7 (25% vs 1%), umbilical artery pH <7.10 (56% vs 10%), hypoglycaemia <2.0 mmol/l (29% vs 3%) and early-onset sepsis/meningitis (14% vs 2%). In the multivariate analysis, maternal fever (OR 10.2; 95% CI 1.3 to 78.5), Apgar score (5 min) <7 (OR 18.1; 95% CI 3.4 to 96.8), hypoglycaemia <2.0 mmol/l (OR 13.0; 95% CI 3.2 to 52.6) and early-onset sepsis/meningitis (OR 5.8; 95% CI 1.1 to 31.9) were significantly associated with PAIS.
  
  
  CONCLUSIONS
  Maternal fever during delivery and early-onset sepsis/meningitis were found to be involved with PAIS as was previously noted. Apgar score (5 min) <7 and hypoglycaemia were found to be important risk factors in term PAIS.
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Harteman
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.forename: Anneke
authors.initials: A
authors.lastname: Kwee
authors.forename: Paco M J
authors.initials: PM
authors.lastname: Welsing
authors.forename: Manon J N L
authors.initials: MJ
authors.lastname: Benders
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
mesh_terms: D001034:Apgar Score; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*