CLINICAL ASSOCIATIONS OF PRENATAL ISCHEMIC WHITE-MATTER INJURY

Neuropathological examinations carried out at necropsy on 274 cases of intrauterine death or neonatal death at or before three days after bi rth. Fifty six (20.4%) subjects had evidence of prenatal ischaemic bra in damage. On review of the maternal case notes to ascertain antenatal clinical associations there was an increased incidence of intrauterin e growth retardation, either based on birth weight for gestational age (odds ratio (OR) 2.0; 95% confidence interval (CI) 1.1 to 3.7) or dia gnosed antenatally (OR 2.7; 95% CI 1.3 to 5.6). Oligohydramnios was al so more common (OR 2.9; 95% CI 1.2 to 7.0). The association of intraut erine growth retardation and white matter damage remained after exclud ing fetuses with a major congenital anomaly (OR 2.4; 95% CI 1.1 to 5.1 ). The findings suggest that chronic intrauterine hypoxia may be assoc iated with damage to cerebral white matter among fetuses and infants w ho die. The relation between ischaemic white matter damage and cerebra l palsy among survivors remains speculative.