M. Topp et al., PRETERM BIRTH AND CEREBRAL-PALSY - PREDICTIVE VALUE OF PREGNANCY COMPLICATIONS, MODE OF DELIVERY, AND APGAR SCORES, Acta obstetricia et gynecologica Scandinavica, 76(9), 1997, pp. 843-848
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.