Prenatal and perinatal factors and cerebral palsy in very low birth weight infants

Grether, Judith K.; Nelson, Karin B.; Emery, Edward S.; Cummins, Susan K.

doi:10.1016/s0022-3476(96)70292-5

Cited by 213 publications

(129 citation statements)

References 17 publications

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“…Mothers with amnionitis may not be candidates for tocolysis and will thus be less likely to receive magnesium sulfate. If amnionitis places them at higher risk for CP, as has also been suggested, 13,14 magnesium sulfate may artifactually seem protective. In our study, these three factors, as best we could ascertain them, were accounted for in the analysis.…”

Section: Discussionmentioning

confidence: 87%

Magnesium Sulfate in Labor and Risk of Neonatal Brain Lesions and Cerebral Palsy in Low Birth Weight Infants

Jetton²,

et al. 1997

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ABSTRACT. Objectives. We tested the hypothesis that administration of magnesium sulfate in labor protects against the development of neonatal brain lesions and cerebral palsy (CP) in low birth weight infants.Methods. Magnesium exposure was ascertained in a population-based cohort of 1105 infants weighing 2000 g or less through review of medical records of maternal magnesium sulfate administration and, where available, elevated maternal serum magnesium levels. Neonatal germinal matrix/intraventricular hemorrhage and parenchymal brain lesions were ascertained by a prospective, timed ultrasound scanning protocol in the first week of life. CP was ascertained at 2 years of age by clinical examination in 80% of survivors and by interview and medical record review in another 6% and was classified as disabling or nondisabling. Conclusions. The hypothesis that magnesium sulfate use reduces the risk of neonatal brain lesions or CP in low birth weight infants was not statistically supported in this study, although a modest reduction in risk of DCP cannot be excluded. The data further suggest that magnesium exposure may be associated with reduction in risk of CP in low birth weight infants who have lateonset brain lesions, but this unpredicted observation requires confirmation in another data set. Pediatrics 1997; 99(5). URL: http://www.pediatrics.org/cgi/content/full/99/ 5/e1; cerebral palsy; magnesium sulfate; infant, low birth weight; preeclampsia; cerebral hemorrhage, infant. Results. No significant reduction in risk of nondisabling CP (adjusted odds ratio [OR

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Section: Discussionmentioning

confidence: 87%

Magnesium Sulfate in Labor and Risk of Neonatal Brain Lesions and Cerebral Palsy in Low Birth Weight Infants

Jetton²,

et al. 1997

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“…Maternal pyrexia in labor is associated with adverse neurologic outcome in term and preterm infants (eg, neonatal seizures, encephalopathy, cerebral palsy, and mortality). [19][20][21][22] It is unclear whether hyperthermia itself causes brain injury or whether other factors (eg, infection, systemic inflammation) cause both a raised temperature and brain injury. 2,23,24 In term animals, hyperthermia appears to increase neuronal cell damage in those at risk for perinatal hypoxiaischemia.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Trial of Exothermic Mattresses for Preterm Newborns in Polyethylene Bags

et al. 2013

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BACKGROUND AND OBJECTIVE: Hypothermia on admission to the NICU is associated with increased mortality in preterm infants. Many newborns are hypothermic on admission despite using polyethylene bags (PBs). Using exothermic mattresses (EMs) in addition to PBs may reduce hypothermia but increase hyperthermia. We wished to determine whether placing preterm newborns in PBs on EMs in the DR results in more infants with rectal temperature outside the range 36.5 to 37.5°C on NICU admission. METHODS: Infants <31 weeks were randomly assigned before birth to treatment with or without an EM. All infants were placed in a PB and under radiant heat immediately after birth and brought to NICU in a transport incubator. Infants randomly assigned to EM were placed on a mattress immediately after delivery and remained on it until admission. Randomization was stratified by gestational age. Rectal temperature was measured with a digital thermometer on NICU admission. RESULTS: The data safety monitoring committee recommended stopping for efficacy after analyzing data from half the planned sample. We report data for 72 infants enrolled at this time. Fewer infants in PBs on EMs had temperatures within the target range (15/37 [41%] vs 27/35 [77%], P = .002) and more had temperatures >37.5°C (17/37 [46%] vs 6/35 [17%], P = .009). CONCLUSIONS: In very preterm newborns, using EMs in addition to PBs in the DR resulted in more infants with temperatures outside the normal range and more hyperthermia on NICU admission.

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“…12 An association between infection and CP has been reported in preterm or low birth weight infants in several studies. [13][14][15][16][17] Several investigators have reported estimates of two-to four-fold increases in risk of CP associated with chorioamnionitis or maternal infection in preterm or very low birth weight infants, but not all reached statistical significance. 16,18 -21 For preterm infants, Wu and Colford 7 reported a summary relative risk of 1.9 (95% CI 1.4 to 2.5) for clinical chorioamnionitis and 1.6 (95% CI 0.9 to 2.7) for histologic chorioamnionitis in her meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

Maternal Infection and Risk of Cerebral Palsy in Term and Preterm Infants

et al. 2004

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We tested the hypothesis that term and preterm infants exposed to maternal infection at the time of delivery are at increased risk of developing cerebral palsy (CP). STUDY DESIGN:A population-based case-control study was conducted using Washington State birth certificate data linked to hospital discharge data. Cases (688) were children r6 years old, singleton births, hospitalized during 1987 to 1999 with an ICD-9 diagnosis code for CP. Controls were 3068 singleton birth infants randomly selected from birth records for the same years without CP-related hospitalizations. Infection information was available only for the birth hospitalization. RESULTS:Infants of women who had any infection during their hospitalization for delivery were at increased risk of CP (odds ratio (OR) 3.1, 95% confidence interval (CI) 2.3 to 4.2). This was observed for term deliveries (OR 1.8, 95% CI 1.1 to 2.8) and preterm deliveries (OR 2.3, 95% CI 1.3 to 4.2). CONCLUSIONS:Our results suggest that maternal infection is a risk factor for CP in both term and preterm infants.

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Prenatal and perinatal factors and cerebral palsy in very low birth weight infants

Cited by 213 publications

References 17 publications

Magnesium Sulfate in Labor and Risk of Neonatal Brain Lesions and Cerebral Palsy in Low Birth Weight Infants

Magnesium Sulfate in Labor and Risk of Neonatal Brain Lesions and Cerebral Palsy in Low Birth Weight Infants

A Randomized Trial of Exothermic Mattresses for Preterm Newborns in Polyethylene Bags

Maternal Infection and Risk of Cerebral Palsy in Term and Preterm Infants

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