Risk factors for cerebral palsy in neonates due to placental abruption

• Published in: The journal of obstetrics and gynaecology research 2021-01, Vol.47 (1), p.159-166
• Main Authors: Ichizuka, Kiyotake, Toyokawa, Satoshi, Ikenoue, Tsuyomu, Satoh, Shoji, Hasegawa, Junichi, Ikeda, Tomoaki, Tamiya, Nanako, Nakai, Akihito, Fujimori, Keiya, Maeda, Tsugio, Kanayama, Naohiro, Masuzaki, Hideaki, Iwashita, Mitsutoshi, Suzuki, Hideaki, Takeda, Satoru
• Format: Article
• Language: English
• Subjects: Alcohol; alcohol consumption; Alcohol use; Cerebral palsy; Confidence intervals; Gynecology; Hypertension; Intravenous administration; Magnesium sulfate; Multivariate analysis; Neonates; Obstetrics; Oral administration; Original; Oxytocin; Paralysis; Placenta; Placental abruption; Population studies; Pregnancy; Risk factors; Smoking
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.14447

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.