Evidence map›Paper›PMID 37848334›Full record

ArticleNeurology2023

Relationship Between Neonatal Brain Injury and Objective Measures of Head Trauma: A Case-Control Study.

Mary Dunbar, Abbey Norris, Brandon T Craig, Kathleen Chaput, Khorshid Mohammad, Lauran Cole, Michael J Esser, Aaron Caughey, Helen Carlson, Adam Kirton

Erratum issuedOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 2 countries.

Mary DunbarFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada.
Abbey NorrisFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada.
Brandon T CraigFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada.ORCID 0000-0003-1222-1284
Kathleen ChaputFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada.
Khorshid MohammadFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada.
Lauran ColeFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada.
Michael J EsserFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada.
Aaron CaugheyFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada.
Helen CarlsonFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada.ORCID 0000-0002-5788-0542
Adam KirtonFrom the Department of Pediatrics (M.D., B.T.C., H.C., A.K.), University of Calgary; Calgary Pediatric Stroke Program (M.D., B.T.C., H.C., A.K.); Alberta Children's Hospital Research Institute (M.D., B.T.C., H.C., A.K.); Hotchkiss Brain Institute (M.D., B.T.C., H.C., A.K.); Pediatric Stroke Program (A.N.); Department of Obstetrics and Gynecology (K.C.); Department of Pediatrics (K.M., M.J.E.), University of Calgary; Department of Pediatrics (L.C.), University of Alberta, Edmonton, Canada; Department of Obstetrics and Gynecology (A.C.), Oregon Health & Science University, Portland, OR; and Department of Clinical Neurosciences and Radiology (A.K.), University of Calgary, Alberta, Canada. adam.kirton@ahs.ca.ORCID 0000-0001-5209-3374
Allen Institute for Brain Science · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesNeonatal brain injury is a common and devastating diagnosis conferring lifelong challenges for children and families. The role of mechanical forces applied to the head, often referred to as "birth trauma," are often considered although evidence for this association is lacking. The objective of this study was to investigate the association between common types of neonatal brain injury and scalp swelling using a novel method to quantify scalp swelling as an unbiased proxy for mechanical forces applied to the head.

methodsCase-control study using population-based, prospectively collected tertiary care center databases and healthy controls from the Human Connectome Development Project. Included were infants born 32-42 weeks gestational age and MRI in the first 9 days. Outcomes categories included healthy neonates, hypoxic ischemic encephalopathy (HIE) with or without brain injury, or stroke (ischemic or hemorrhagic). Volume of scalp swelling was objectively quantified by a novel imaging method blinded to brain injury. Variables included mode of delivery and use of instrumentation. Statistical tests included Kruskal-Wallis test, chi square, and multivariable and multinomial logistic regression.

resultsThere were 309 infants included (55% male): 72 healthy controls, 77 HIE without brain injury on MRI, 78 HIE with brain injury, and 82 with stroke (60 ischemic, 22 hemorrhagic). Scalp swelling was present in 126 (40.8%, 95% confidence interval [CI] 35.2%-46.5%) with no difference in proportions between outcome groups. Compared to healthy controls, median volume was higher in those with HIE without brain injury (17.5 mL, 95% CI 6.8-28.2), HIE with brain injury (12.1 mL, 95% CI 5.5-18.6), but not ischemic stroke (4.7 mL, 95% CI -1.2-10.6) nor hemorrhagic stroke (8.3 mL, 95% CI -2.2-18.8). Scalp swelling was associated with instrumented delivery (OR 2.1, 95% CI 1.0-4.1), but not associated with increased odds of brain injury in those with HIE (OR 1.5, 95% CI 0.76-3.30). Scalp swelling measures were highly reliable (ICC = 0.97). DISCUSSION: "Birth trauma" quantified by scalp swelling volume was more common in infants with difficult deliveries, but not associated with greater odds of brain injury due to hypoxia or stroke. These results may help parents and practitioners to dissociate the appearance of trauma with the risk of brain injury.

Indexed as

Brain InjuriesCraniocerebral TraumaHypoxia-Ischemia, BrainStrokeCase-Control StudiesChildFemaleHumansInfantInfant, NewbornMagnetic Resonance ImagingMale

Identifiers

PMID37848334
PMCPMC10752635
OpenAlexW4387699020

What OpenQuestion holds

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Registered trials

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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.