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Acta Obstet Gynecol Scand. 2011 Jan;90(1):83-91. doi: 10.1111/j.1600-0412.2010.01022.x. Epub 2010 Nov 26.

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

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  • 1Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. areej.elkamil@ntnu.no

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.

© 2010 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2010 Nordic Federation of Societies of Obstetrics and Gynecology.

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PMID:
21275920
[PubMed - indexed for MEDLINE]
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