Kiyotake Ichizuka1,2, Satoshi Toyokawa1,3, Tsuyomu Ikenoue1,4, Shoji Satoh1,5, Junichi Hasegawa1,6, Tomoaki Ikeda1,7, Nanako Tamiya1,8, Akihito Nakai1,9, Keiya Fujimori1,10, Tsugio Maeda1,11, Naohiro Kanayama1,12, Hideaki Masuzaki1,13, Mitsutoshi Iwashita1,14, Hideaki Suzuki1, Satoru Takeda1,15. 1. Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan. 2. Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Japan. 3. Department of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. 4. Department of Obstetrics and Gynecology, Faculty of Medicine, Miyazaki University, Miyazaki, Japan. 5. Department of Obstetrics, Oita Prefectural Hospital, Oita, Japan. 6. Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan. 7. Department of Obstetrics and Gynecology, Mie University, Tsu, Japan. 8. Department of Health Services Research, Faculty of Medicine, Tsukuba University, Tsukuba, Japan. 9. Department of Obstetrics and Gynecology, Nippon Medical University, Tokyo, Japan. 10. Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan. 11. Maeda Obstetrics and Gynecology Clinic, Yaizu, Japan. 12. Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan. 13. Department of Obstetrics and Gynecology, Nagasaki University, Nagasaki, Japan. 14. Kugayama Hospital, Tokyo, Japan. 15. Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.
Abstract
AIM: This study aimed to identify risk factors for the onset of cerebral palsy (CP) in neonates due to placental abruption and investigate their characteristics. METHODS: A retrospective case-control study was conducted using a nationwide registry from Japan. The study population included pregnant women (n = 122) who delivered an infant with CP between 2009 and 2015, where placental abruption was identified as the single cause of CP. The control group consisted of pregnant women with placental abruption, who delivered an infant without CP and were managed from 2013 to 2014. They were randomly identified from the prenatal database of the Japan Society of Obstetrics and Gynecology (JSOG-DB; n = 1214). Risk factors were investigated using multivariate analysis. RESULTS: Alcohol consumption (3.38, 2.01-5.68) (odds ratio, 95% confidence interval), smoking during pregnancy (3.50, 1.32-9.25), number of deliveries (1.28, 1.05-1.56), polyhydramnios (5.60, 1.37-22.6), oral administration of ritodrine hydrochloride (2.09, 1.22-3.57) and hypertensive disorders in pregnancy (2.25, 1.27-4.07) were significant risk factors. In contrast, intravenous administration of oxytocin (odds ratio, 95% confidence interval: 0.22, 0.09-0.58) and magnesium sulfate (0.122, 0.02-0.89) attenuated risk. CONCLUSION: Alcohol consumption, smoking during pregnancy, number of deliveries, polyhydramnios, oral administration of ritodrine hydrochloride and hypertensive disorders in pregnancy were identified as risk factors for CP following placental abruption. Regarding alcohol consumption and smoking during pregnancy, the results suggest the importance of educational activities targeting pregnant women to increase their awareness of placental abruption.
AIM: This study aimed to identify risk factors for the onset of cerebral palsy (CP) in neonates due to placental abruption and investigate their characteristics. METHODS: A retrospective case-control study was conducted using a nationwide registry from Japan. The study population included pregnant women (n = 122) who delivered an infant with CP between 2009 and 2015, where placental abruption was identified as the single cause of CP. The control group consisted of pregnant women with placental abruption, who delivered an infant without CP and were managed from 2013 to 2014. They were randomly identified from the prenatal database of the Japan Society of Obstetrics and Gynecology (JSOG-DB; n = 1214). Risk factors were investigated using multivariate analysis. RESULTS:Alcohol consumption (3.38, 2.01-5.68) (odds ratio, 95% confidence interval), smoking during pregnancy (3.50, 1.32-9.25), number of deliveries (1.28, 1.05-1.56), polyhydramnios (5.60, 1.37-22.6), oral administration of ritodrine hydrochloride (2.09, 1.22-3.57) and hypertensive disorders in pregnancy (2.25, 1.27-4.07) were significant risk factors. In contrast, intravenous administration of oxytocin (odds ratio, 95% confidence interval: 0.22, 0.09-0.58) and magnesium sulfate (0.122, 0.02-0.89) attenuated risk. CONCLUSION:Alcohol consumption, smoking during pregnancy, number of deliveries, polyhydramnios, oral administration of ritodrine hydrochloride and hypertensive disorders in pregnancy were identified as risk factors for CP following placental abruption. Regarding alcohol consumption and smoking during pregnancy, the results suggest the importance of educational activities targeting pregnant women to increase their awareness of placental abruption.
Authors: Colleen M O'Leary; Linda Watson; Heather D'Antoine; Fiona Stanley; Carol Bower Journal: Dev Med Child Neurol Date: 2012-01-23 Impact factor: 5.449
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