Preterm birth and cerebral palsy - Predictive value of pregnancy complications, mode of delivery, and Apgar scores

Background. Preterm infants are at 8 times higher risk than term infants for pre-and perinatal brain damage, resulting in cerebral palsy, In this paper we have analysed the influence of prenatal and birth-related risk factors on cerebral palsy in preterm infants. Methods. In a register-based study, 175 preterm singleton infants with cerebral palsy, born in 1982-86, were compared with 687 controls matched by gestational age and year of birth. Results. Statistically significant higher rates in cases were found in parity greater than or equal to 3 (22% vs. 16%, p<0.05), Cesarean section (67% vs. 56%, p<0.01), and low Apgar scores at 1 minute (45% vs. 36%, p<0.05). By multivariate analyses, two variables remained statistically significant: parity greater than or equal to 3 (adjusted OR=1.53 (95% CI 1.00-2.34), p<0.05) and Cesarean section (adjusted OR=1.57 (95% CI 1.07-2.32), p<0.05). Conclusions. Pregnancy complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited.