Title

Maternal antenatal complications and the risk of neonatal cerebral white matter damage and later cerebral palsy in children born at an extremely low gestational age

UMMS Affiliation

Department of Obstetrics and Gynecology

Date

10-29-2009

Document Type

Article

Medical Subject Headings

Cerebral Palsy; Cerebral Ventricles; Female; Fetal Growth Retardation; Humans; Infant, Newborn; *Infant, Premature; Leukomalacia, Periventricular; Male; Multivariate Analysis; Obstetric Labor Complications; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Prospective Studies; Risk; United States; Uterine Cervical Incompetence

Disciplines

Obstetrics and Gynecology

Abstract

In a 2002-2004 prospective cohort study of deliveries of infants at <28 weeks at 14 US>centers, the authors sought the antecedents of white matter damage evident in newborn cranial ultrasound scans (ventriculomegaly and an echolucent lesion) and of cerebral palsy diagnoses at age 2 years. Of the 1,455 infants enrolled, those whose mothers received an antenatal steroid tended to have lower risks of ventriculomegaly and an echolucent lesion than their peers (10% vs. 23%, P < 0.001 and 7% vs. 11%, P = 0.06, respectively). Risk of ventriculomegaly was increased for infants delivered because of preterm labor (adjusted odds ratio (OR) = 2.3, 95% confidence interval (CI): 1.1, 4.9), preterm premature rupture of fetal membranes (OR = 3.6, 95% CI: 1.5, 8.7), and cervical insufficiency (OR = 2.8, 95% CI: 1.4, 5.5) when compared with infants delivered because of preeclampsia. Risk of an echolucent lesion was increased for infants delivered because of preterm labor (OR = 2.7, 95% CI: 1.2, 5.7) and intrauterine growth retardation (OR = 3.3, 95% CI: 1.2, 9.4). The doubling of diparesis risk associated with preterm labor and with preterm premature rupture of fetal membranes did not achieve statistical significance, nor did the doubling of quadriparesis risk and the tripling of diparesis risk associated with cervical insufficiency.

Rights and Permissions

Citation: Am J Epidemiol. 2009 Oct 1;170(7):819-28. Epub 2009 Aug 27. Link to article on publisher's site

Comments

Francis Bednarek, Gamze Ayata, and Ellen Delpapa participated in this study as ELGAN Study Investigators.

Related Resources

Link to Article in PubMed