Induction of labor and cerebral palsy: a population-based study in Norway.

Abstract:

OBJECTIVE:To investigate the association between labor induction and later development of cerebral palsy (CP). DESIGN:Registry-based cohort study. SETTING:Perinatal data on all children born in Norway 1996-1998 were obtained from the Medical Birth Registry of Norway (MBRN). Neurodevelopmental data were collected from the Norwegian Cerebral Palsy Registry (CPRN). POPULATION:A total of 176,591 children surviving the neonatal period. Of 373 children with CP, detailed data were available on 241. METHODS:Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated as estimates of the relative risk that a child with CP was born after labor induction. MAIN OUTCOME MEASURES:Total CP and spastic CP subtypes. RESULTS:Bilateral cerebral palsy was more frequently observed after induced labor (OR: 3.1; 95% CI 2.1-4.5). For children born at term the association between bilateral CP and labor induction was stronger (OR: 4.4; 95% CI 2.3-8.6). The association persisted after adjustment for maternal disease, gestational age, standard deviation score for birthweight (z-score) and prelabor rupture of membranes (PROM) (adjusted OR: 3.7; 95%CI 1.8-7.5). Among children with CP born at term, four-limb involvement (quadriplegia) was significantly more frequent after induced (45.5%) compared with non-induced labor (8.0%). There was no significant association between labor induction and unilateral CP subtype or CP in preterm born children. CONCLUSIONS:In this study population, we found that labor induction at term was associated with excess risk of bilateral spastic CP and in particular CP with four-limb involvement.

authors

Elkamil AI,Andersen GL,Salvesen KÅ,Skranes J,Irgens LM,Vik T

doi

10.1111/j.1600-0412.2010.01022.x

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

83-91

issue

1

eissn

0001-6349

issn

1600-0412

journal_volume

90

pub_type

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