Diseases and Injuries of the Term Newborn 623 20 2003 Task Force applied these criteria to more -18 contemporaneous outcomes and determined ) that only 1.6 cases of cerebral palsy per 10,000 ) deliveries are attributable solely to intrapartum hypoxia. This finding is supported by a study ) ) U.
1975 to 1980 (Stanley, 1991). Other stud :)0 (Phelan, 1996; Strijbis, 2006).
Year of birth Despite persistent attempts to validate con
Elective and emergency cesarean deliveries and live births with cerebral palsy. (Reproduced with permission from Nelson KB, Blair E: Prenatal factors in singletons ing as efective to prevent adverse perinatal with cerebral palsy born at or near term, N Engl J Med. 201o5 Sep 3;373(10):946-953.) outcomes, evidence does not support its ability to predict or reduce cerebral palsy risk such as maternal mental retardation or fetal congenital malformations; (2) birthweight <2000 g; (3) birth before 32 weeks; and (4) perinatal infection. hey also found that obstetrical complications were not strongly predictive, and only a fifth of afected children had markers of perinatal asphyxia. For the irst time, there was solid evidence that the cause of most cases of cerebral palsy was unknown, and importanty, ony a small proportion was caused by neonatal HI. Equally importantly, there was no foreseeable single intervention that would likely prevent a large proportion of cases.
Numerous studies have since confirmed many of these findings and identiied an imposing list of other risk factors that are shown in Table 33-2. As expected, preterm birth continues to be the single most important risk factor (Nelson, 2015; (Clark, 2003; hacker, 1995). Importantly, no speciic fetal heart rate patterns predict cerebral palsy. Further, no relationship has been found between the clinician's response to abnormal patterns and neurological outcome. And, eforts using assisted computer analysis of fetal
TABLE 33-2. Perinatal Risk Factors Reported to Be Increased in Children with Cerebral Palsy
Hydramnios 6.9 1n.0-49.3
Placental abruption 7.6 2.7-21.1
Interval between pregnancies 3.7 1.0-4.4 1.7-6.7