Risk factors for perinatal stroke in term infants: A case–control study in Australia. (14th February 2023)

• Record Type: Journal Article
• Authors: Roy, Bithi; Webb, Annabel; Walker, Karen; Morgan, Catherine; Badawi, Nadia; Novak, Iona
• Is Part Of: Journal of paediatrics and child health. Volume 59:Number 4(2023)
• Page Start: 673
• Page End: 679
• Publication Date: 2023-02-14
• Subjects: aetiology -- neonatology -- neurology -- perinatal stroke -- risk factors; Children -- Health and hygiene -- Periodicals; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/jpc.16372
• Languages: English
• ISSNs: 1034-4810

Abstract

Abstract : Aim: The aetiology of perinatal stroke is poorly understood. This study aimed to prospectively confirm the risk factors and identify any previously unknown variables. Methods: A prospective case–control study was conducted in Australia. Univariate odds ratios (ORs), associated 95% confidence intervals (CIs) and multivariable logistic regression models fitted with backwards stepwise variable selection were used. Results: Sixty perinatal stroke cases reported between 2017 and 2019 included 95% (57/60) with multiple risk factors. Univariate analysis identified emergency caesarean section rather than NVD ( P < 0.01), low Apgar score (<7) at 1, 5 and 10 min of age ( P < 0.01), resuscitation at birth ( P < 0.01), abnormal cord blood gas ( P < 0.01), neonatal infection/sepsis ( P < 0.01), congenital heart disease ( P < 0.01) and hypoglycaemia ( P < 0.01) as significant risk factors. Multivariate analysis found smoking during pregnancy (OR: 1.48; 95% CI: 1.09–1.99), 1‐min Apgar score < 7 (OR: 1.54; 95% CI: 1.15–2.08), 10‐min Apgar score < 7 (OR: 1.26; 95% CI: 1.02–1.54) and hypoglycaemia (OR: 1.49; 95% CI: 1.07–2.06). Conclusions: Perinatal stroke is associated with multiple risk factors. Exposure to smoking, 10‐min Apgar score < 7, neonatal infection and hypoglycaemia were independent risk factors. Emergency caesarean section, resuscitation at birth and abnormal cord blood gas were additional risk factors.