No abstract

Aim To identify maternal, obstetric, and neonatal risk factors related to perinatal arterial ischaemic stroke (PAIS) diagnosed within 28 days after birth and to understand the underlying pathophysiology. Method For case and control ascertainment, we used active surveillance in 345 paediatric hospitals and a population‐based perinatal database for quality assurance of hospital care. We analysed complete cases of PAIS using logistic regression. Multivariate analysis was guided by a directed acyclic graph. Results After exclusion of records with missing data, we analysed 134 individuals with PAIS and 576 comparison individuals. In univariate analysis, male sex, preterm birth (<37wks gestational age), small for gestational age (SGA), low umbilical artery pH (<7.1), low 5‐minute‐Apgar score (<7), multiple pregnancies, hypoxia, intubation/mask ventilation, nulliparity, Caesarean section, vaginal‐operative delivery, chorioamnionitis, and oligohydramnios were associated with an increased risk. Mutual adjustment yielded male sex (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.20–2.73), multiple birth (OR 3.22; 95% CI 1.21–8.58), chorioamnionitis (OR 9.89; 95% CI 2.88–33.94), preterm birth (OR 1.86; 95% CI 1.01–3.43), and SGA (OR 3.05; 95% CI 1.76–5.28) as independent risk factors. Interpretation We confirmed the increased risk in males and the role of chorioamnionitis and SGA for PAIS, pointing to the importance of inflammatory processes and fetal–placental insufficiency. Multiple birth and preterm birth were additional risk factors. What this paper adds Chorioamnionitis and small for gestational age (SGA) precede perinatal arterial ischaemic stroke (PAIS). Chorioamnionitis and SGA are independent risk factors for PAIS. Inflammatory processes and fetal–placental insufficiency are the likely underlying mechanisms. Multiple birth and preterm birth are additional risk factors.

HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Assessment of spontaneous movements of infants lets trained experts predict neurodevelopmental disorders like cerebral palsy at a very young age, allowing early intervention for affected infants. An automated motion analysis system requires to accurately capture body movements, ideally without markers or attached sensors to not affect the movements of infants. A vast majority of recent approaches for human pose estimation focuses on adults, leading to a degradation of accuracy if applied to infants. Hence, multiple systems for infant pose estimation have been developed. Due to the lack of publicly available benchmark data sets, a standardized evaluation, let alone a comparison of different approaches is impossible. We fill this gap by releasing the Moving INfants In RGB-D (MINI-RGBD) † data set, created using the recently introduced Skinned Multi-Infant Linear body model (SMIL). We map real infant movements to the SMIL model with realistic shapes and textures, and generate RGB and depth images with precise ground truth 2D and 3D joint positions. We evaluate our data set with state-of-the-art methods for 2D pose estimation in RGB images and for 3D pose estimation in depth images. Evaluation of 2D pose estimation results in a PCKh rate of 88.1% and 94.5% (depending on correctness threshold), and PCKh rates of 64.2%, respectively 90.4% for 3D pose estimation. We hope to foster research in medical infant motion analysis to get closer to an automated system for early detection of neurodevelopmental disorders.

No abstract