• C Greenwood, P Yudkin, S Sellers, L Impey, and P Doyle.
• National Perinatal Epidemiology Unit and The Women's Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK. Catherine.Greenwood@orh.nhs.uk
• Arch. Dis. Child. Fetal Neonatal Ed. 2005 Mar 1; 90 (2): F141-6.

ObjectiveTo investigate risk factors for cerebral palsy in relation to gestational age.DesignThree case-control studies within a geographically defined cohort.SettingThe former Oxfordshire Health Authority.ParticipantsA total of 235 singleton children with cerebral palsy not of postnatal origin, born between 1984 and 1993, identified from the Oxford Register of Early Childhood Impairment; 646 controls matched for gestation in three bands: or=37 weeks.ResultsMarkers of intrapartum hypoxia and infection were associated with an increased risk of cerebral palsy in term and preterm infants. The odds ratio (OR) for hypoxia was 12.2 (95% confidence interval 1.2 to 119) at or=37 weeks. Corresponding ORs for neonatal sepsis were 3.1 (1.8 to 5.4) and 10.6 (2.1 to 51.9). In contrast, pre-eclampsia carried an increased risk of cerebral palsy at >or=37 weeks (OR 5.1 (2.2 to 12.0)) but a decreased risk at ConclusionInflammatory processes, including pre-eclampsia, are important in the aetiology of cerebral palsy. The apparent reduced risk of cerebral palsy associated with pre-eclampsia in very preterm infants is driven by the characteristics of the gestation matched control group. Use of the term "protective" in this context should be abandoned.

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