Cerebral palsy and perinatal arterial ischaemic stroke.

Objective: Approximately 24% of children with hemiplegia and 10% of those with cerebral palsy (CP) have imaging evidence of perinatal arterial ischaemic stroke (PAIS). The aim of this study was to investigate potential risk factors for PAIS in children with CP, with particular emphasis on maternal and child blood groups. The secondary aim was to examine differences in the frequency of selected antenatal and perinatal variables between children with neonatally symptomatic and neonatally asymptomatic PAIS. Design(s): Retrospective cohort and nested case-control study. Method(s): Reports of magnetic resonance imaging (MRI) and computerised tomography (CT) scans were searched for evidence of PAIS in 1-18 year old children who were registered with the Victorian CP Register. PAIS was defined as infarction conforming to a major arterial territory. Sixty-two mother-child pairs participated and provided information on blood groups (mean age of children 8y 0m [SD 4y 9mo]; 40 male, 22 female). Additional antenatal, perinatal, and clinical variables were extracted from the Victorian CP Register and medical records. The frequency of variables previously reported to be associated with CP was compared with the reported population frequency, as well as between the symptomatic and asymptomatic groups. Result(s): Sixteen mothers (26%) in the PAIS group were rhesus negative (Rh(D) ); this was higher than the 17% reported in the population for Caucasians (p=0.065). There were no statistically significant differences for maternal or child Rh(D) and ABO blood groups, nor for Rh(D) or ABO incompatibility. The proportions of male sex, primiparity and primigravidity, small for gestational age, and unplanned caesarean delivery in the PAIS group were statistically different from the frequencies in the Victorian population (p<0.05). Neonatal seizures and nursery admission were also more common in the PAIS group. Compared to the asymptomatic PAIS group (n=45), mothers of children in the early s