ANTENATAL ANTECEDENTS OF MODERATE AND SEVERE CEREBRAL-PALSY

Aetiological relationships between cerebral palsy, preterm birth, smal l-for-gestational-age (SGA) birth and selected fete-maternal factors w ere investigated in a case-control study of all moderate and severe ce rebral palsy cases born in Western Australia between 1980 and 1986 (n = 215). Cases were individually matched to three controls of the same gender and plurality born in the same year. Two of the controls were m atched to the index eases for gestational age, one of which was also m atched for birthweight. Pre-eclampsia and urinary tract infections wer e not significantly associated with cerebral palsy. The significant as sociation of antepartum haemorrhage with cerebral palsy was accounted for by its associations with preterm birth. Congenital malformations a nd non-cerebral palsy neurological disorder were significantly associa ted with cerebral palsy; these associations were only partially accoun ted for by adjusting for preterm birth and small-for-gestational-age b irth. This study shows that some of the risk of cerebral palsy associa ted with the antenatal antecedents of some common fete-maternal factor s is mediated through preterm birth, confirming the importance of inte rrelationships between antenatal antecedents in the aetiology of some cerebral palsy. Perinatal and post-neonatal causes now account for onl y around 20% of all cerebral palsy. Future reductions in cerebral pals y incidence may therefore depend on acquiring greater knowledge of int er-relationships between antenatal antecedents.