Maternal and Infant Characteristics Associated With Perinatal Arterial Stroke in the Infant

Abstract

ERINATAL ARTERIAL ISCHEMIC stroke (PAS) is an important cause of cerebral palsy and other neurologic disabilities, including epilepsy and cognitive impairment. [1][2][3][4][5][6][7] Arterial ischemic stroke is diagnosed primarily in neonates born at term 8,9 and is responsible for 50% to 70% of congenital hemiplegic cerebral palsy in this population. 10,11 The cause of PAS is poorly understood. Investigators have reported a number of obstetric and neonatal complications in the setting of PAS, including birth asphyxia, preeclampsia, chorioamnionitis, cardiac anomalies, polycythemia, and systemic infection. 7,[12][13][14][15] Others have failed to find a significant difference in the frequency of perinatal complications between infants with PAS and controls. 1 6 Hematologic disorders, including factor V Leiden mutation and hyperhomocysteinemia, may also play a role in the pathogenesis of PAS. 14,[17][18][19] Previous studies of PAS are subject to a number of important limitations. Most describe only a small number of children 7,12,16,[20][21][22] or lack an adequate comparison group. 8,14,23 We found previously that preeclampsia and intrauterine growth restriction are independent risk factors for PAS. 15 However, our earlier

Incidence and Outcomes of Symptomatic Neonatal Arterial Ischemic Stroke

“…13,[16][17][18] Three of the population-based studies included NAIS (presentation during the neonatal period) and PPIS (diagnosed retrospectively). 2,12,14 Two population-based studies included only NAIS. 10,15 To allow a comparison with the current study, only cases with NAIS should be considered ( Table 1).…”

“…25 The majority of patients in our study had unilateral lesions in anterior circulation on the left side, consistent with populations in previous studies. 2,14,20 Anatomic settings and variable vulnerability to ischemic lesions might explain why the left side is more commonly involved. 27,29 We found NAIS to be associated with maternal conditions, birth complications, and neonatal comorbidities.…”

“…Hospital-and population-based studies in North America and Europe have provided epidemiologic data suggesting that the incidence of ischemic perinatal stroke is between 5 and 43 per 100 000 live births. 2,[10][11][12][13][14][15][16][17][18] Studies have shown that about half of patients become symptomatic during the neonatal period. 14 A summary of epidemiologic studies on NAIS and PPIS is presented in Table 1.…”

Migraine and preterm birth

“…Data in this study suggest that about 20% of preterm birth was mediated by the association with pre-eclampsia. Pre-eclampsia is itself associated with pre-term birth, perinatal death 3 and with infant stroke in the perinatal period, 24 and also with risk of maternal pregnancy-associated stroke 7 and with long-term stroke risk in the mother. 4 In preeclampsia, 25,26 as in migraine, 27,28 there are features of endothelial dysfunction, platelet activation and inflammation.…”

Etiopathogenic Bases for the Formation of Cerebral Palsy in Children (Reference Review)

“…Повышается риск перинатального инсульта при при-менении вакуумного пособия в родах, при экстренном родоразрешении путем кесарева сечения, при оценке по шкале Апгар<7 на 5 мин, лихорадке матери выше 38 гр., гипогликемии [31,32].…”