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Aim To determine whether macrosomic infants with a birthweight of 4.0 kg or more have increased risk of cerebral palsy associated with neonatal encephalopathy ( Enc- CP). Methods A retrospective review of 132 singleton infants with Enc- CP fulfilling all of the following criteria: born at gestational week ( GW) 37 or more ( n = 126) or weighing 2.5 kg or more at birth ( n = 116) in or after January 2009 in Japan; no identifiable causes of cerebral palsy other than antenatal or intrapartum hypoxia; and exhibition of neonatal encephalopathy. National statistics of Japan were used to determine the numbers of infants according to birthweight categories. Results Of the 116 infants with a birthweight of 2.5 kg or more, 46 (39.7%), 49 (42.2%), 17 (14.7%) and four (3.4%) infants had birthweights of 2.5-2.99, 3.0-3.49, 3.5-3.99 and 4.0 kg or more, respectively. Corresponding figures among Japanese infants born in 2009-2011 were 42.8%, 45.4%, 10.9% and 0.90%, respectively. Infants with a birthweight of 4.0 kg or more had a relative risk (95% confidence interval) of Enc- CP of 3.89 (1.52-9.95) compared to those with a birthweight of 2.5-2.99 kg. Conclusion Japanese infants with a birthweight of 4.0 kg or more have increased risk of Enc- CP. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to determine whether the use of transcervical balloon catheter ( TCBC) for induction of labor ( IOL) is a risk factor for cerebral palsy ( CP) associated with umbilical cord prolapse ( UCP-CP) in singleton pregnancies with cephalic presentation. Material and Methods Among all 102 infants with CP who were preliminarily determined as caused by antenatal and/or intrapartum hypoxemia by the Japan Council for Quality Health Care until April 2012, all 56 infants who met all of the following criteria were studied: cephalic singleton pregnancy, reassuring fetal status on electronic cardiotocogram at time of admission to obstetric facilities for labor pains, ruptured fetal membranes, and/or IOL, and hypoxic-ischemic encephalopathy at birth. Clinical backgrounds were compared between six infants with UCP-CP and the remaining 50 infants with CP not associated with UCP (non- UCP-CP). Results Frequencies of IOL (83% [5/6] vs 32% [16/50], P = 0.0236), use of TCBC (67% [4/6] vs 10% [5/50], P = 0.0044), and amniotomy (67% [4/6] vs 24% [12/50], P = 0.0494) were significantly higher in the UCP-CP than the non- UCP-CP group. Only TCBC was a risk factor significantly associated with UCP-CP after logistic regression analysis, yielding an odds ratio of 18.0 (95% confidence interval, 2.6-124; P = 0.003). Saline volumes of 80-150 mL were used for TCBC inflation in the four UCP-CP patients. Conclusion Use of TCBC with a saline volume ≥ 80 mL was a significant risk factor for UCP-CP; however, the absolute risk of UCP-CP was estimated to be very low, approximately one in 7875 TCBC users. [ABSTRACT FROM AUTHOR]