Perinatal stroke risk factors: Syndrome-controlled analysis in the Canadian Cerebral Palsy Registry

摘要: Objectives: Perinatal stroke causes most hemiparetic cerebral palsy (CP). Pathophysiology is unknown with limited case-control studies. Comparisons to related disease states may provide unique insight. The population-based Canadian CP registry (CCPR) collects imaging and >70 risk factor variables. We hypothesized that perinatal strokes carry profiles within populations. Methods: CCPR enrolls children across 13 centers. Systematic chart reviews parental interviews acquire >150 variables including potential factors. Data current June 2013 was extracted (RedCAP) analyzed. Imaging reports for cases were classified as: (1) definitive (arterial or venous), (2) probable stroke, (3) not (alternate diagnosis), (4) inconclusive. Risk compared between two control groups: CP, all other CP. Univariate analysis informed multivariate logistic regression. Results: Of 1168 (57% male, median 42±23mos), the common phenotype (28%). Definitive (158, 49%) non-stroke (109, 34%) 67% arterial (33% venous). Comparing found seven univariate associations but none persisted on analysis. types demonstrated independent preeclampsia (2.35;1.11-4.95;p=0.025), prematurity (0.165;0.093-0.293; p<0.001), maternal drug use (5.03;2.05-12.35;p<0.0001) male gender (1.47;0.997-2.19;p=0.058). Conclusions: registries are a valuable source of disease-specific etiologies stroke. Stroke-specific factors include previously (male gender) inconsistently (preeclampsia) reported novel (maternal drugs). Syndrome-controlled approaches inform pathogenesis.