Prenatal Risk Factors For Neurological Abnormalities In The Term And Near Term Neonate

An abnormal neurological examination in the neonatal hospital stay may indicate a transient or permanent neurological disturbance. Abnormal neurological symptoms therefore place an infant at increased risk for subsequent neurological problems.;This case-control study was designed to investigate prenatal and perinatal risk factors for an abnormal neurological examination in the term infant. Infants were born between 1 January, 1988 and 30 June, 1990. The sample consisted of 222 neonates with neurological abnormalities and 666 controls who were free of such problems. Data on the prenatal histories of their mothers, course of the pregnancy, intrapartum events and status of the infant after birth were collected by chart review. Risk factors were identified through univariate analysis of possible factors, followed by multivariate logistic regression.;First delivery, 2 or more spontaneous abortions, maternal diabetes, rh positive blood type, and a history of migraine headaches were identified as prepregnancy risk factors. Diminished weight or length for gestational age and pregnancy-induced hypertension were risk factors of pregnancy. Intra- and postpartum factors which were found to confer risk included placental abruption, disproportion, maternal fever in labour, placental abnormalities and respiratory distress, hypoglycaemia, anaemia and sepsis in the infant. Other risk factors which appeared in various sub-analyses included maternal drug allergies, maternal hypertension, fetal anomalies and placental infection.;When variables of all three time periods were allowed to compete, 2 or more previous abortions, maternal drug allergies, diminished weight for gestational age in the fetus, maternal-fetal disproportion and placental abruption remained significant prenatal risk factors, after controlling for respiratory distress, hypoglycaemia, anaemia and sepsis in the infant, as well as maternal age, marital status, height, body mass index, weight gain in pregnancy, first delivery and sex of the infant. In women whose family history was available, diabetes in family members, pregnancy-induced hypertension and diminished length for gestational age in the infant appeared as additional significant risk factors, but drug allergies was not significant.;This study concentrates on part of a postulated causal pathway between prenatal events and neurological impairment, and focuses on term infants. The associations identified here should be confirmed in prospective studies