Characteristics of Pregnancy Course in an Infant With Cerebral Palsy Showing Decreased Fetal Movement

TL;DR

This study examines the characteristics of pregnancies in infants with cerebral palsy who showed decreased fetal movement, identifying hypoxia and placental issues as common causes.

Contribution

The study identifies specific clinical patterns and risk factors in cerebral palsy cases associated with decreased fetal movement.

Findings

Hypoxia was the most common cause of cerebral palsy in cases with decreased fetal movement.

Fetomaternal hemorrhage cases had longer durations from decreased fetal movement to delivery compared to placental abruption.

Velamentous or marginal cord insertion was associated with increased risk of cerebral palsy.

Abstract

To clarify the characteristics of patients with cerebral palsy (CP) showing decreased fetal movement (DFM).

Among patients with CP between January 2009 and February 2021, we collected cases of DFM from the causal analysis report. We retrieved the clinical course and the causes of CP.

Of 2834 cases of CP, 225 (8%) patients were included in this study. Some form of hypoxia was the most common cause (117 cases, 52%) followed by placental abruption (45 cases, 20%) and fetomaternal hemorrhage (FMH) (32 cases, 14%). The duration from DFM to delivery was longer in cases of FMH than in placental abruption (p < 0.001). The duration less than 6 h was only observed in one (4%) case of FMH, whereas it was observed in 32 (73%) cases of placental abruption. In contrast, the cases with durations of more than 24 h accounted for 36% (10/28) in FMH cases. Next, we focused on hypoxia cases. Marginal or velamentous insertion accounted for 21% (22/106) of the hypoxia cases. Umbilical artery pH and base excess were worse in cases of normal site insertion than those of marginal or velamentous insertion.

DFM was seen in 8% of patients with CP. FMH required more time from the DFMs to delivery than cases of placental abruption. Fetuses with a velamentous or marginal cord insertion may have a risk of CP.

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