Risk factors associated with cerebral palsy in preterm infants.

OBJECTIVE

To examine pregnancy outcomes in preterm delivered children with cerebral palsy (CP).

METHODS

A retrospective population-based cohort study of children born in California (January 1, 1991 and December 31, 2001) with CP were identified (State databases) and compared to children without CP. We examined demographic data and pregnancy outcomes by gestational age groups controlling for multiple co-founders.

RESULTS

Of 2733 preterm infants (total of 8397, 33% <37 weeks of gestation) with CP, delivery <28 weeks had the largest impact upon the development of CP (Odds ratio (OR) 18.2 95%CI (16.7, 19.9)) with delivery 28-31 6/7 weeks having less impact (OR 8.8 (8.0, 9.7) when compared to term deliveries. Birth asphyxia (OR 5.9 (5.3, 6.6) was associated with the future development of CP as were birth defects (OR 4.3 (4.1. 4.5), cord prolapse (OR 2.0 (1.6, 2.4)) and fetal distress (OR 2.1 (1.9, 2.2)) the latter 2 being less so.

CONCLUSION

Prematurity had the greatest impact upon the future development of CP; however, birth asphyxia, birth defects and adverse labor events contributed significantly to the future development of CP as well, suggesting that the cause of CP in the preterm infant is most likely multifactorial.