390 Cerebral Palsy and Neonatal Death in Singletons Born small for Gestational Age at Term

ObjectivesTo investigate known and suggested risk factors associated with cerebral palsy in a Swedish birth cohort, stratified by gestational age.SettingInformation on all births between 1995 and 2014 in Skåne, the southernmost region in Sweden, was extracted from the national birth register.ParticipantsThe cohort comprised a total of 215 217 children. Information on confirmed cerebral palsy and subtype was collected from the national quality register for cerebral palsy (Cerebral Palsy Follow-up Surveillance Programme).Primary and secondary outcome measuresWe calculated the prevalence of risk factors suggested to be associated with cerebral palsy and used logistic regression models to investigate the associations between potential risk factors and cerebral palsy. All analyses were stratified by gestational age; term (≥37 weeks), moderately or late preterm (32–36 weeks) and very preterm (<32 weeks).ResultsIn all, 381 (0.2 %) children were assigned a cerebral palsy diagnosis. Among term children, maternal preobesity/obesity, small for gestational age, malformations, induction, elective and emergency caesarian section, Apgar <7 at 5 min and admission to neonatal care were significantly associated with cerebral palsy (all p values<0.05). Among children born moderately or late preterm, small for gestational age, malformations, elective and emergency caesarian section and admission to neonatal care were all associated with cerebral palsy (all p values <0.05), whereas among children born very preterm no factors were significantly associated with the outcome (all p values>0.05).ConclusionOur results support and strengthen previous findings on factors associated with cerebral palsy. The complete lack of significant associations among children born very preterm probably depends on to the small number of children with cerebral palsy in this group.

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Cerebral palsy: Phenotypes and risk factors in term singletons born small for gestational age

European Journal of Paediatric Neurology ◽

10.1016/j.ejpn.2014.12.005 ◽

2015 ◽

Vol 19 (2) ◽

pp. 218-225 ◽

Cited By ~ 12

Author(s):

Gabrielle Freire ◽

Michael Shevell ◽

Maryam Oskoui

Keyword(s):

Risk Factors ◽

Cerebral Palsy ◽

Gestational Age ◽

Small For Gestational Age

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85: What is the optimal timing of delivery for the early preterm small for gestational age fetus? Balancing the risks of stillbirth with neonatal death

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2013.10.118 ◽

2014 ◽

Vol 210 (1) ◽

pp. S55-S56

Author(s):

Amanda Trudell ◽

Methodius Tuuli ◽

Alison Cahill ◽

George Macones ◽

Anthony Odibo

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Neonatal Death ◽

Optimal Timing

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Term complications and subsequent risk of preterm birth: registry based study

BMJ ◽

10.1136/bmj.m1007 ◽

2020 ◽

pp. m1007

Author(s):

Liv G Kvalvik ◽

Allen J Wilcox ◽

Rolv Skjærven ◽

Truls Østbye ◽

Quaker E Harmon

Keyword(s):

Preterm Birth ◽

Relative Risk ◽

Preterm Delivery ◽

Gestational Age ◽

Small For Gestational Age ◽

Neonatal Death ◽

Placental Abruption ◽

Reverse Direction ◽

Birth Registry ◽

Increased Risk

AbstractObjectiveTo explore conditions and outcomes of a first delivery at term that might predict later preterm birth.DesignPopulation based, prospective register based study.SettingMedical Birth Registry of Norway, 1999-2015.Participants302 192 women giving birth (live or stillbirth) to a second singleton child between 1999 and 2015.Main outcome measuresMain outcome was the relative risk of preterm delivery (<37 gestational weeks) in the birth after a term first birth with pregnancy complications: pre-eclampsia, placental abruption, stillbirth, neonatal death, and small for gestational age.ResultsWomen with any of the five complications at term showed a substantially increased risk of preterm delivery in the next pregnancy. The absolute risks for preterm delivery in a second pregnancy were 3.1% with none of the five term complications (8202/265 043), 6.1% after term pre-eclampsia (688/11 225), 7.3% after term placental abruption (41/562), 13.1% after term stillbirth (72/551), 10.0% after term neonatal death (22/219), and 6.7% after term small for gestational age (463/6939). The unadjusted relative risk for preterm birth after term pre-eclampsia was 2.0 (95% confidence interval 1.8 to 2.1), after term placental abruption was 2.3 (1.7 to 3.1), after term stillbirth was 4.2 (3.4 to 5.2), after term neonatal death was 3.2 (2.2 to 4.8), and after term small for gestational age was 2.2 (2.0 to 2.4). On average, the risk of preterm birth was increased 2.0-fold (1.9-fold to 2.1-fold) with one term complication in the first pregnancy, and 3.5-fold (2.9-fold to 4.2-fold) with two or more complications. The associations persisted after excluding recurrence of the specific complication in the second pregnancy. These links between term complications and preterm delivery were also seen in the reverse direction: preterm birth in the first pregnancy predicted complications in second pregnancies delivered at term.ConclusionsPre-eclampsia, placental abruption, stillbirth, neonatal death, or small for gestational age experienced in a first term pregnancy are associated with a substantially increased risk of subsequent preterm delivery. Term complications seem to share important underlying causes with preterm delivery that persist from pregnancy to pregnancy, perhaps related to a mother’s predisposition to disorders of placental function.

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The association of cerebral palsy and death with small-for-gestational-age birthweight in preterm neonates by individualized and population-based percentiles

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2013.06.007 ◽

2013 ◽

Vol 209 (4) ◽

pp. 340.e1-340.e5 ◽

Cited By ~ 14

Author(s):

William A. Grobman ◽

Yinglei Lai ◽

Dwight J. Rouse ◽

Catherine Y. Spong ◽

Michael W. Varner ◽

...

Keyword(s):

Cerebral Palsy ◽

Gestational Age ◽

Small For Gestational Age ◽

Population Based ◽

Preterm Neonates

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Prevalence of Speech Problems and the Use of Augmentative and Alternative Communication in Children With Cerebral Palsy: A Registry-Based Study in Norway

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac19.1.12 ◽

2010 ◽

Vol 19 (1) ◽

pp. 12-20 ◽

Cited By ~ 29

Author(s):

Guro Andersen ◽

Tone R. Mjøen ◽

Torstein Vik

Keyword(s):

Cerebral Palsy ◽

Motor Function ◽

Gestational Age ◽

Augmentative And Alternative Communication ◽

Alternative Communication ◽

Gross Motor ◽

Gross Motor Function ◽

Children With Cerebral Palsy ◽

Communicative Abilities ◽

Normal Speech

Abstract This study describes the prevalence of speech problems and the use of augmentative and alternative communication (AAC) in children with cerebral palsy (CP) in Norway. Information on the communicative abilities of 564 children with CP born 1996–2003, recorded in the Norwegian CP Registry, was collected. A total of 270 children (48%) had normal speech, 90 (16%) had slightly indistinct speech, 52 (9%) had indistinct speech, 35 (6%) had very indistinct speech, 110 children (19%) had no speech, and 7 (1%) were unknown. Speech problems were most common in children with dyskinetic CP (92 %), in children with the most severe gross motor function impairments and among children being totally dependent on assistance in feeding or tube-fed children. A higher proportion of children born at term had speech problems when compared with children born before 32 weeks of gestational age 32 (p > 0.001). Among the 197 children with speech problems only, 106 (54%) used AAC in some form. Approximately 20% of children had no verbal speech, whereas ~15% had significant speech problems. Among children with either significant speech problems or no speech, only 54% used AAC in any form.

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