title: Risk factors for cerebral palsy in PPROM and preterm delivery with intact membranes (.).
abstract: OBJECTIVE
  Gestational age (GA) at delivery and spontaneous prematurity are independent risk factors for cerebral palsy (CP). The aim of this study is to investigate perinatal risk factors for CP in spontaneous preterm delivery.
  
  
  METHODS
  A retrospective cohort study of all single pregnancies complicated by spontaneous preterm labor (PTL) or PPROM with delivery at <34 weeks from January 2006 to December 2012 was performed. We compared demographic, obstetric, neonatal, and placental histology variables in cases of spontaneous preterm birth in reference to the development of CP. Statistical analysis included chi-square, one-way ANOVA and logistic regression analysis. p < 0.05 was considered significant.
  
  
  RESULTS
  Two hundred sixty-one women were included for this study. Of 249 survivors, 5 babies died during the first year of life, 52 did not fulfill the inclusion criteria for neurologic follow-up, and 24 were lost to follow up. Thus 168 infants in the study cohort underwent neurologic follow-up. We observed 26 cases of CP. Factors related to CP were lower GA at PROM (p = 0.007) and longer latency from PPROM to delivery (p = 0.002) in the PPROM group, lower GA at delivery (p < 0.001) and presence of funisitis (p <0.001) in the PTL group.
  
  
  CONCLUSIONS
  GA at membrane rupture in PPROM and GA at delivery in PTL are significantly associated with CP. A process leading to neurological damage may be initiated at the moment of membranes rupture in cases of PPROM and at the time of PTL in the group with intact membranes.
authors.affiliation: a Department of Obstetrics and Gynecology , San Gerardo Hospital MBBM Foundation, University of Milano-Bicocca , Monza , Italy .
authors.forename: Federica
authors.initials: F
authors.lastname: Accordino
authors.affiliation: a Department of Obstetrics and Gynecology , San Gerardo Hospital MBBM Foundation, University of Milano-Bicocca , Monza , Italy .
authors.forename: Sara
authors.initials: S
authors.lastname: Consonni
authors.affiliation: b Department of Neonatology , San Gerardo Hospital, University of Milano-Bicocca , Monza , Italy .
authors.forename: Tiziana
authors.initials: T
authors.lastname: Fedeli
authors.affiliation: c Department of Child Neurology and Psychiatry , San Gerardo Hospital, University of Milano-Bicocca , Monza , Italy .
authors.forename: Gaia
authors.initials: G
authors.lastname: Kullman
authors.affiliation: d Department of Pathology , San Gerardo Hospital, University of Milano-Bicocca , Monza , Italy , and.
authors.forename: Francesca
authors.initials: F
authors.lastname: Moltrasio
authors.affiliation: e Georgetown University , Washington , USA.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ghidini
authors.affiliation: a Department of Obstetrics and Gynecology , San Gerardo Hospital MBBM Foundation, University of Milano-Bicocca , Monza , Italy .
authors.forename: Anna
authors.initials: A
authors.lastname: Locatelli
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000209:etiology*; D016009:Chi-Square Distribution; D002821:Chorioamnionitis / Q000175:diagnosis; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D007234:Infant, Premature; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Cerebral palsy; PPROM; neurological outcome; prematurity; preterm birth