%0 Journal Article %1 Thorngren-Jerneck2006 %A Thorngren-Jerneck, Kristina %A Herbst, Andreas %D 2006 %J Obstet Gynecol %K Abruptio Placentae; Apgar Score; Birth Weight; Breech Presentation; Case-Control Studies; Cerebral Palsy; Cesarean Section; Confidence Intervals; Diabetes, Gestational; Emergencies; Female; Humans; Infant, Newborn; Premature; Male; Maternal Age; Obstetrical Forceps; Odds Ratio; Parity; Pre-Eclampsia; Pregnancy; Risk Factors; Sex Smoking; Sweden %N 6 %P 1499--1505 %R 10.1097/01.AOG.0000247174.27979.6b %T Perinatal factors associated with cerebral palsy in children born in Sweden. %U http://dx.doi.org/10.1097/01.AOG.0000247174.27979.6b %V 108 %X OBJECTIVE: To identify perinatal factors associated with cerebral palsy (CP). METHODS: This was a case-control study based on the Swedish Medical Birth Registry and the Swedish Hospital Discharge Registry, including 2,303 infants born in Sweden 1984-1998 with a diagnosis of CP and 1.6 million infants without this diagnosis. Odds ratios (ORs) with 95\% confidence intervals (CIs) were calculated. RESULTS: Infants born preterm had a highly increased risk for CP, and constituted 35\% of all cases; OR 34 (95\% CI 29-39) in weeks 23-27, OR 37 (95\% CI 32-42) in weeks 28-29, OR 26 (95\% CI 23-30) in weeks 30-31, and OR 3.9 (95\% CI 3.4-4.4) in weeks 32-36. Boys had a higher risk (sex ratio 1.36:1), particularly before term (sex ratio 1.55:1). Other factors associated with CP were being small or large for gestational age at birth, abruptio placentae (OR 8.6, 95\% CI 5.6-13.3), maternal insulin-dependent diabetes mellitus type 1 (OR 2.1, 95\% CI 1.4-3.1), preeclampsia (OR 1.5, 95\% CI 1.3-2.4), being a twin (OR 1.4, 95\% CI 1.1-1.6), maternal age older than 40 years (OR 1.4, 95\% CI 1.1-1.8) or 35-39 years (OR 1.2, 95\% CI 1.1-1.4), primiparity (OR 1.2, 95\% CI 1.1-1.3), and smoking (OR 1.2, 95\% CI 1.1-1.3). In term infants, low Apgar scores were associated with a high risk for CP; OR 62 (95\% CI 52-74) at score 6 at 5 minutes, OR 498 (95\% CI 458-542) at score 3. Other factors associated with CP in term infants were breech presentation at vaginal birth (OR 3.0, 95\% CI 2.4-3.7), instrumental delivery (OR 1.9, 95\% CI 1.6-2.3), and emergency cesarean delivery (OR 1.8, 95\% CI 1.6-2.0). CONCLUSION: Preterm birth entails a high risk for CP, but 65\% of these children are born at term. Several obstetric factors and low Apgar scores are associated with CP. LEVEL OF EVIDENCE: II-2.

@article{Thorngren-Jerneck2006, abstract = {OBJECTIVE: To identify perinatal factors associated with cerebral palsy (CP). METHODS: This was a case-control study based on the Swedish Medical Birth Registry and the Swedish Hospital Discharge Registry, including 2,303 infants born in Sweden 1984-1998 with a diagnosis of CP and 1.6 million infants without this diagnosis. Odds ratios (ORs) with 95\% confidence intervals (CIs) were calculated. RESULTS: Infants born preterm had a highly increased risk for CP, and constituted 35\% of all cases; OR 34 (95\% CI 29-39) in weeks 23-27, OR 37 (95\% CI 32-42) in weeks 28-29, OR 26 (95\% CI 23-30) in weeks 30-31, and OR 3.9 (95\% CI 3.4-4.4) in weeks 32-36. Boys had a higher risk (sex ratio 1.36:1), particularly before term (sex ratio 1.55:1). Other factors associated with CP were being small or large for gestational age at birth, abruptio placentae (OR 8.6, 95\% CI 5.6-13.3), maternal insulin-dependent diabetes mellitus type 1 (OR 2.1, 95\% CI 1.4-3.1), preeclampsia (OR 1.5, 95\% CI 1.3-2.4), being a twin (OR 1.4, 95\% CI 1.1-1.6), maternal age older than 40 years (OR 1.4, 95\% CI 1.1-1.8) or 35-39 years (OR 1.2, 95\% CI 1.1-1.4), primiparity (OR 1.2, 95\% CI 1.1-1.3), and smoking (OR 1.2, 95\% CI 1.1-1.3). In term infants, low Apgar scores were associated with a high risk for CP; OR 62 (95\% CI 52-74) at score 6 at 5 minutes, OR 498 (95\% CI 458-542) at score 3. Other factors associated with CP in term infants were breech presentation at vaginal birth (OR 3.0, 95\% CI 2.4-3.7), instrumental delivery (OR 1.9, 95\% CI 1.6-2.3), and emergency cesarean delivery (OR 1.8, 95\% CI 1.6-2.0). CONCLUSION: Preterm birth entails a high risk for CP, but 65\% of these children are born at term. Several obstetric factors and low Apgar scores are associated with CP. LEVEL OF EVIDENCE: II-2.}, added-at = {2014-07-19T21:43:15.000+0200}, author = {Thorngren-Jerneck, Kristina and Herbst, Andreas}, biburl = {https://www.bibsonomy.org/bibtex/24bbfdd54e51ad4cecf8d6e167a941126/ar0berts}, doi = {10.1097/01.AOG.0000247174.27979.6b}, groups = {public}, interhash = {ce1dcf95cfbc72f51da82717b4132300}, intrahash = {4bbfdd54e51ad4cecf8d6e167a941126}, journal = {Obstet Gynecol}, keywords = {Abruptio Placentae; Apgar Score; Birth Weight; Breech Presentation; Case-Control Studies; Cerebral Palsy; Cesarean Section; Confidence Intervals; Diabetes, Gestational; Emergencies; Female; Humans; Infant, Newborn; Premature; Male; Maternal Age; Obstetrical Forceps; Odds Ratio; Parity; Pre-Eclampsia; Pregnancy; Risk Factors; Sex Smoking; Sweden}, month = Dec, number = 6, pages = {1499--1505}, pii = {108/6/1499}, pmid = {17138786}, timestamp = {2014-07-19T21:48:36.000+0200}, title = {Perinatal factors associated with cerebral palsy in children born in Sweden.}, url = {http://dx.doi.org/10.1097/01.AOG.0000247174.27979.6b}, username = {ar0berts}, volume = 108, year = 2006 }