TY  - JOUR
AB  - Developmental Medicine  &  Child Neurology published by John Wiley  &  Sons Ltd on behalf of Mac Keith Press. Aim: To describe the incidence of term and preterm neonatal cerebral sinovenous thrombosis (CSVT) and identify perinatal risk factors. Method: This was a national capture-recapture calculation-corrected surveillance and nested case–control study. Infants born preterm and at term with magnetic resonance imaging-confirmed neonatal CSVT were identified by surveillance in all paediatric hospitals in Germany (2015–2017). Incidence was corrected for underreporting using a capture-recapture method in one federal state and then extrapolated nationwide. We reviewed PubMed for comparisons with previously reported incidence estimators. We used a population-based perinatal database for quality assurance to select four controls per case and applied univariate and multivariable regression for risk factor analysis. Results: Fifty-one newborn infants (34 males, 17 females; 14 born preterm) with neonatal CSVT were reported in the 3-year period. The incidence of term and preterm neonatal CSVT was 6.6 (95% confidence interval [CI] 4.4–8.7) per 100 000 live births. Median age at time of confirmation of the diagnosis was 9.95 days (range 0–39d). In the univariate analysis, male sex, preterm birth, hypoxia and related indicators (umbilical artery pH <7.1; 5-minute Apgar score <7; intubation/mask ventilation; perinatal asphyxia), operative vaginal delivery, emergency Caesarean section, and pathological fetal Doppler sonography were associated (p<0.05) with neonatal CSVT. Multivariable regression yielded hypoxia (odds ratio=20.3; 95% CI 8.1–50.8) as the independent risk factor. Interpretation: Incidence of neonatal CSVT was within the range of other population-based studies. The results suggest that hypoxia is an important perinatal risk factor for the aetiology of neonatal CSVT.
AU  - Sorg, A.L.*
AU  - von Kries, R.*
AU  - Klemme, M.*
AU  - Gerstl, L.*
AU  - Beyerlein, A.
AU  - Lack, N.*
AU  - Felderhoff-Müser, U.*
AU  - Dzietko, M.*
C1  - 61152
C2  - 50070
CY  - 111 River St, Hoboken 07030-5774, Nj Usa
SP  - 697-704
TI  - Incidence and risk factors of cerebral sinovenous thrombosis in infants.
JO  - Dev. Med. Child. Neurol.
VL  - 63
IS  - 6
PB  - Wiley
PY  - 2021
SN  - 0012-1622
ER  - 

TY  - JOUR
AB  - Aim: To identify maternal, obstetric, and neonatal risk factors related to perinatal arterial ischaemic stroke (PAIS) diagnosed within 28 days after birth and to understand the underlying pathophysiology. Method: For case and control ascertainment, we used active surveillance in 345 paediatric hospitals and a population-based perinatal database for quality assurance of hospital care. We analysed complete cases of PAIS using logistic regression. Multivariate analysis was guided by a directed acyclic graph. Results: After exclusion of records with missing data, we analysed 134 individuals with PAIS and 576 comparison individuals. In univariate analysis, male sex, preterm birth (<37wk gestational age), small for gestational age (SGA), low umbilical artery pH (<7.1), low 5-minute-Apgar score (<7), multiple pregnancies, hypoxia, intubation/mask ventilation, nulliparity, Caesarean section, vaginal-operative delivery, chorioamnionitis, and oligohydramnios were associated with an increased risk. Mutual adjustment yielded male sex (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.20–2.73), multiple birth (OR 3.22; 95% CI 1.21–8.58), chorioamnionitis (OR 9.89; 95% CI 2.88–33.94), preterm birth (OR 1.86; 95% CI 1.01–3.43), and SGA (OR 3.05; 95% CI 1.76–5.28) as independent risk factors. Interpretation: We confirmed the increased risk in males and the role of chorioamnionitis and SGA for PAIS, pointing to the importance of inflammatory processes and fetal–placental insufficiency. Multiple birth and preterm birth were additional risk factors. What this paper adds: Chorioamnionitis and small for gestational age (SGA) precede perinatal arterial ischaemic stroke (PAIS). Chorioamnionitis and SGA are independent risk factors for PAIS. Inflammatory processes and fetal–placental insufficiency are the likely underlying mechanisms. Multiple birth and preterm birth are additional risk factors.
AU  - Sorg, A.-L.*
AU  - von Kries, R.*
AU  - Klemme, M.*
AU  - Gerstl, L.*
AU  - Weinberger, R.*
AU  - Beyerlein, A.
AU  - Lack, N.*
AU  - Felderhoff-Müser, U.*
AU  - Dzietko, M.*
C1  - 56897
C2  - 47267
SP  - 513-520
TI  - Risk factors for perinatal arterial ischaemic stroke: A large case–control study.
JO  - Dev. Med. Child. Neurol.
VL  - 62
IS  - 4
PY  - 2019
SN  - 0012-1622
ER  -