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 infan ts for pre-and perinatal brain damage, resulting in cerebral palsy, In this paper we have analysed the influence of prenatal and birth-relat ed risk factors on cerebral palsy in preterm infants. Methods. In a re gister-based study, 175 preterm singleton infants with cerebral palsy, born in 1982-86, were compared with 687 controls matched by gestation al age and year of birth. Results. Statistically significant higher ra tes in cases were found in parity greater than or equal to 3 (22% vs. 16%, p<0.05), Cesarean section (67% vs. 56%, p<0.01), and low Apgar sc ores at 1 minute (45% vs. 36%, p<0.05). By multivariate analyses, two variables remained statistically significant: parity greater than or e qual to 3 (adjusted OR=1.53 (95% CI 1.00-2.34), p<0.05) and Cesarean s ection (adjusted OR=1.57 (95% CI 1.07-2.32), p<0.05). Conclusions. Pre gnancy complications preceding preterm birth did not imply a higher ri sk of cerebral palsy. Delivery by Cesarean section was a prognostic fa ctor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited.