Placental infarction identified by macroscopic examination and risk of cerebral palsy in infants at 35 weeks of gestational age and over.

摘要

OBJECTIVE: We sought to investigate whether placental infarction determined by macroscopic examination was associated with risk of cerebral palsy (CP). STUDY DESIGN: This was a population-based study of macroscopic placental infarcts in singletons >35 weeks' gestational age, in 158 perinatal deaths, 445 infants with CP, and 491 controls matched with CP cases for gestational age. RESULTS: Placental infarcts were recorded in 2.0% of controls, 4.4% of deaths (relative risk [RR], 2.2; 95% confidence interval [CI], 0.8-5.6]), 5.2% of infants with CP (P < .05, RR, 2.5; 95% CI, 1.2-5.3), and 8.4% with spastic quadriplegic CP (P = .0026; RR, 4.4; 95% CI, 1.8-10.6). In children with CP, unlike controls, placental infarction was associated with reduced fetal growth, older maternal age, more prior miscarriages, and poor neonatal condition, but not with maternal preeclampsia. CONCLUSION: Placental infarction identified by macroscopic examination was associated with increased risk of CP and the CP subtype, spastic quadriplegic CP. Antecedents of placental infarction differed in children with CP compared with control children.