Prevalence & Risk Factors for Perinatal Stroke: A Population-Based Study

Author:

Roy Bithi123ORCID,Webb Annabel4,Walker Karen25,Morgan Catherine14,Badawi Nadia146,Nunez Carlos27ORCID,Eslick Guy27,Kent Alison L89,Hunt Rod W41011,Mackay Mark T121314,Novak Iona24

Affiliation:

1. The University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia

2. Faculty of Medicine and Health, The University of Sydney, Sydney, Australia

3. The University of Notre Dame Australia, Sydney, Australia

4. Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia

5. RPA Newborn Care, Sydney Local Health District, Sydney, New South Wales, Australia

6. Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney, Australia

7. The Australian Paediatric Surveillance Unit, Sydney, Australia

8. University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

9. Australian National University College of Health and Medicine, Canberra, ACT, Australia

10. Dept of Paediatrics, Monash University, Melbourne, Australia

11. Monash Newborn, Monash Health, Melbourne, Australia

12. Department of Neurology, Royal Children's Hospital, Parkville, Australia

13. Neuroscience Research, Murdoch Children's Research Institute, Parkville, Australia

14. Department of Paediatrics, University of Melbourne, Parkville, Australia

Abstract

Objectives The study objective was to calculate the birth prevalence of perinatal stroke and examine risk factors in term infants. Some risk factors are present in healthy infants, making it difficult to determine at-risk infants. Study Design Prospective population-based perinatal stroke data were compared to the Australian general population data using chi-squared and Fisher's exact tests and multivariable logistic regression analysis. Results Sixty perinatal stroke cases were reported between 2017 and 2019. Estimated stroke prevalence was 9.6/100,000 live births/year including 5.8 for neonatal arterial ischemic stroke and 2.9 for neonatal hemorrhagic stroke. Eighty seven percent had multiple risk factors. Significant risk factors were cesarean section ( p = 0.04), 5-min Apgar score <7 ( p < 0.01), neonatal resuscitation ( p < 0.01) and nulliparity ( p < 0.01). Conclusions Statistically significant independent risk factors do not fully explain the cause of perinatal stroke, because they are not a direct causal pathway to stroke. These data now require validation in a case-control study.

Publisher

SAGE Publications

Subject

General Economics, Econometrics and Finance

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