ArticleInternational journal of epidemiology2022
Impact of gestational age on risk of cerebral palsy: unravelling the role of neonatal morbidity.
Article in International journal of epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Born at higher risk: persistent male excess risk of cerebral palsy from extreme prematurity to term: a systematic review and meta-analysis.Biology of sex differences · 2026Pooled it
- The impact of premature birth and low birth weight on motor, visual, and cognitive skills and mental health in adolescence: a systematic review and meta-analysis.European child & adolescent psychiatry · 2026Pooled it
- Nutritional status and functions in children with cerebral palsy at different gestational ages.Pediatric investigation · 2026Article
- High ambient temperature during pregnancy and offspring cerebral palsy: A population-based case-control study in California.Environmental research · 2026Article
- Modeling cerebral palsy in animals.Developmental medicine and child neurology · 2026Review
- A sibling study of the prenatal and perinatal risks for cerebral palsy.Pediatric research · 2025Article
- Risk factors for spastic cerebral palsy: a retrospective cross-sectional study and literature review.Italian journal of pediatrics · 2025Review
- Preterm birth is associated with dystonic features and reduced cortical parvalbumin immunoreactivity in mice.Pediatric research · 2025Article
- Impact of assisted reproductive technology on the risk of cerebral palsy: A systematic review and meta-analysis.Pakistan journal of medical sciences · 2025Review
- Ambient Toxic Air Contaminants in the Maternal Residential Area during Pregnancy and Cerebral Palsy in the Offspring.Environmental health perspectives · 2025Article
- Approaching the paradoxical relationship between hypertensive disorders of pregnancy and cerebral palsy among infants born very preterm with very low birth weight.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Cerebral Palsy and Motor Impairment After Extreme Prematurity: Prediction of Diagnoses at Ages 2 and 10 Years.The Journal of pediatrics · 2024Article
- The Prevalence and Risk Analysis of Cerebral Palsy and Other Neuro-Psychological Comorbidities in Children with Low Birth Weight in Taiwan: A Nationwide Population-Based Cohort Study.Journal of clinical medicine · 2024Article
- Mice born preterm develop gait dystonia and reduced cortical parvalbumin immunoreactivity.bioRxiv : the preprint server for biology · 2024Article
- Neurological development in children born moderately or late preterm: national cohort study.BMJ (Clinical research ed.) · 2024Article
- Cerebral Palsy Heterogeneity: Clinical Characteristics and Diagnostic Significance from a Large-Sample Analysis.Neuroepidemiology · 2024Article
- Pre-pregnancy and pregnancy disorders, pre-term birth and the risk of cerebral palsy: a population-based study.International journal of epidemiology · 2023Article
- Season of Conception and Risk of Cerebral Palsy.JAMA network open · 2023Article
- Risk factors for cerebral palsy and movement difficulties in 5-year-old children born extremely preterm.Pediatric research · 2023Article
- Low Apgar score and asphyxia complications at birth and risk of longer-term cardiovascular disease: a nationwide population-based study of term infants.The Lancet regional health. Europe · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThe contribution of adverse consequences of preterm birth to gestational-age-related risk of cerebral palsy (CP) has rarely been studied. We aimed to assess the potential mediating roles of neonatal morbidity on the association between gestational age and risk of CP.
methodsIn this Swedish population-based study, 1 402 240 singletons born at 22-40 gestational weeks during 1998-2016 were followed from day 28 after birth for a CP diagnosis until 2017. Potential mediators included asphyxia, respiratory-related, infection-/inflammatory-related and neurological-related diseases within 0-27 days of life. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Causal mediation analysis was performed to estimate the proportion of the association mediated through pathways involving the four sequential mediators.
resultsWe found an inverse dose-response relationship between gestational age and risk of CP, where the strongest association was observed for 22-24 weeks (HR 47.26, 95% CI 34.09-65.53) vs 39-40 weeks. Compared with non-diseased peers, children with neonatal morbidity, particularly those with neurological-related diseases (HR 31.34, 95% CI 26.39-37.21), had a higher risk of CP. The increased risk of CP was, at 24 weeks, almost entirely explained by neonatal morbidity (91.7%); this proportion decreased to 46.1% and 16.4% at 32 and 36 weeks, respectively. Asphyxia was the main mediating pathway from 22 to 34 weeks, and neurological-related neonatal diseases led the mediating pathways from 34 weeks onwards.
conclusionNeonatal morbidity mediates a large proportion of the effect of preterm birth on CP, but the magnitude declines as gestational age increases.
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Registered trials
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