ArticleArchives of disease in childhood. Fetal and neonatal edition2005
Why is there a modifying effect of gestational age on risk factors for cerebral palsy?
Article in Archives of disease in childhood. Fetal and neonatal edition, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- SGA as a Risk Factor for Cerebral Palsy in Moderate to Late Preterm Infants: a System Review and Meta-analysis.Scientific reports · 2016Pooled it
- Melatonin for women in pregnancy for neuroprotection of the fetus.The Cochrane database of systematic reviews · 2016Pooled it
- Maternal Hypertension and Adverse Neurodevelopment in a Cohort of Preterm Infants.JAMA network open · 2025Article
- The Global Pregnancy Collaboration (CoLab) symposium on short- and long-term outcomes in offspring whose mothers had preeclampsia: A scoping review of clinical evidence.Frontiers in medicine · 2022Article
- Article
- Preeclampsia and Neurodevelopmental Outcomes: Potential Pathogenic Roles for Inflammation and Oxidative Stress?Molecular neurobiology · 2021Review
- The Antenatal and Postnatal Consequences of Antenatal Exposure to Prolonged Low Dose Indomethacin.Journal of clinical medicine · 2021Article
- Associations between antenatal and perinatal risk factors and cerebral palsy: a Swedish cohort study.BMJ open · 2020Article
- Maternal hypertension and survival in singletons and twins born at 23-29 weeks: not just one answer….Pediatric research · 2019Article
- Causal inference in studies of preterm babies: a simulation study.BJOG : an international journal of obstetrics and gynaecology · 2018Article
- Confounding, causality, and confusion: the role of intermediate variables in interpreting observational studies in obstetrics.American journal of obstetrics and gynecology · 2017Article
- Disproportionate fetal growth and the risk for congenital cerebral palsy in singleton births.PloS one · 2015Article
- Risk of cerebral palsy in relation to pregnancy disorders and preterm birth: a national cohort study.Developmental medicine and child neurology · 2014Article
- Risk of cerebral palsy among the offspring of immigrants.PloS one · 2014Article
- Mediators of the association between pre-eclampsia and cerebral palsy: population based cohort study.BMJ (Clinical research ed.) · 2013Article
- Intra-partum fever and cerebral palsy in Khartoum, Sudan.BMC research notes · 2013Article
- Contemporary clinical management of the cerebral complications of preeclampsia.Obstetrics and gynecology international · 2013Review
- On the pitfalls of adjusting for gestational age at birth.American journal of epidemiology · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate risk factors for cerebral palsy in relation to gestational age.
designThree case-control studies within a geographically defined cohort.
settingThe former Oxfordshire Health Authority.
participantsA total of 235 singleton children with cerebral palsy not of postnatal origin, born between 1984 and 1993, identified from the Oxford Register of Early Childhood Impairment; 646 controls matched for gestation in three bands: <or=32 weeks; 33-36 weeks; >or=37 weeks.
resultsMarkers of intrapartum hypoxia and infection were associated with an increased risk of cerebral palsy in term and preterm infants. The odds ratio (OR) for hypoxia was 12.2 (95% confidence interval 1.2 to 119) at <or=32 weeks and 146 (7.4 to 3651) at >or=37 weeks. Corresponding ORs for neonatal sepsis were 3.1 (1.8 to 5.4) and 10.6 (2.1 to 51.9). In contrast, pre-eclampsia carried an increased risk of cerebral palsy at >or=37 weeks (OR 5.1 (2.2 to 12.0)) but a decreased risk at <or=32 weeks (OR 0.4 (0.2 to 1.0)). However, all infants <or=32 weeks with maternal pre-eclampsia were delivered electively, and their risk of cerebral palsy was no lower than that of other electively delivered <or=32 week infants (OR 0.9 (0.3 to 2.7)). Nearly 60% of <or=32 week controls were delivered after spontaneous preterm labour, itself an abnormal event.
conclusionInflammatory processes, including pre-eclampsia, are important in the aetiology of cerebral palsy. The apparent reduced risk of cerebral palsy associated with pre-eclampsia in very preterm infants is driven by the characteristics of the gestation matched control group. Use of the term "protective" in this context should be abandoned.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.