Prenatal, perinatal and neonatal risk factors for perinatal arterial ischaemic stroke

Li C, Miao JK, Xu Y, Hua YY, Ma Q, Zhou LL, Liu HJ, Chen QX. Prenatal, perinatal and neonatal risk factors for perinatal arterial ischaemic stroke: a systematic review and meta-analysis. Eur J Neurol. 2017 Jun 24. doi:10.1111/ene.13337. [Epub ahead of print]

Abstract

The aim of the present study was to perform a meta-analysis of published data to determine the significance of clinical factors and exposures to the risk of perinatal arterial ischaemic stroke (PAIS) and provide guidance for clinical diagnosis and treatment. A comprehensive literature search of the PubMed, Embase, MEDLINE and Cochrane Library databases for relevant observational studies (cohort/case-control) from March 1984 to March 2016 was undertaken. Two review authors independently examined the full text records to determine which studies met the inclusion criteria and evaluated risk factors for PAIS. Risk ratios, odds ratios and 95% confidence intervals were estimated. A total of 11 studies were included in the analyses. Intrapartum fever >38°C, pre-eclampsia, oligohydramnios, primiparity, forceps delivery, vacuum delivery, fetal heart rate abnormalities, abnormal cardiotocography tracing, cord abnormalities, birth asphyxia, emergency caesarean section, tight nuchal cord, meconium-stained amniotic fluid, umbilical arterial pH <7.10, Apgar score at 5 min <7, resuscitation at birth, hypoglycaemia, male gender and small for gestational age were identified as risk factors for PAIS. This systemic review and meta-analysis provides a preliminary evidence-based assessment of the risk factors for PAIS. Patients with any of the risk factors identified in this analysis should be given careful consideration to ensure the prevention of PAIS. Future studies focusing on the combined effects of multiple prenatal, perinatal and neonatal risk factors for PAIS are warranted.

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The physicians performed a meta–analysis of published data to ascertain the significance of clinical factors and exposures to the risk of perinatal arterial ischaemic stroke (PAIS) and provide guidance for clinical diagnosis and treatment. They provided a preliminary evidence–based assessment of the risk factors for PAIS. Patients with any of the risk factors identified in this analysis needed to be given careful consideration to ensure the prevention of PAIS. Future investigations focusing on the combined effects of multiple prenatal, perinatal and neonatal risk factors for PAIS were warranted.

Methods

From March 1984 to March 2016, the physicians undertook a comprehensive literature search of the PubMed, Embase, MEDLINE and Cochrane Library databases for relevant observational studies (cohort/case-control).

To determine which studies met the inclusion criteria, 2 review authors independently examined the full-text records and assessed risk factors for PAIS.

They estimated risk ratios, odds ratios, and 95% confidence intervals.

Results

The physicians included 11 studies in the analyses.

Factors identified as risk for PAIS were intrapartum fever >38°C, pre-eclampsia, oligohydramnios, primiparity, forceps delivery, vacuum delivery, fetal heart rate abnormalities, abnormal cardiotocography tracing, cord abnormalities, birth asphyxia, emergency caesarean section, tight nuchal cord, meconium-stained amniotic fluid, umbilical arterial pH <7.10, Apgar score at 5 min <7, resuscitation at birth, hypoglycaemia, male gender and small for gestational age.

https://www.mdlinx.com/neurology/medical-news-article/2017/06/29/prenatal-perinatal-arterial-ischaemic-stroke-systematic/7226652/?category=latest&page_id=1