Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/81036
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Type: Journal article
Title: Cesarean delivery and cerebral palsy: A systematic review and meta-analysis
Author: O'Callaghan, M.
MacLennan, A.
Citation: Obstetrics and Gynecology, 2013; 122(6):1169-1175
Publisher: Lippincott Williams & Wilkins
Issue Date: 2013
ISSN: 0029-7844
1873-233X
Organisation: Robinson Institute
Statement of
Responsibility: 
Michael O’Callaghan, and Alastair MacLennan
Abstract: OBJECTIVE: To examine the association of cesarean delivery and cerebral palsy using a systematic literature review and meta-analysis. DATA SOURCES: MEDLINE, Embase, and ClinicalTrials. gov were systematically searched for articles relating to cerebral palsy and cesarean delivery from inception until December 2012. Only articles reporting confirmed cases of cerebral palsy were included. Meta-analysis was used to assess combined results and also the following subgroups: emergency cesarean; elective cesarean; term delivery; preterm delivery; and delivery of breech-presenting newborns. METHODS OF STUDY SELECTION: Literature searches returned 1,874 articles with 58 considered in full. Studies were selected if they reported an endpoint of cerebral palsy, an intervention or risk of cesarean delivery, were in English, and gave sufficient details to perform meta-analysis. TABULATION, INTEGRATION, AND RESULTS: Nine case–control and four cohort studies were included in the overall analysis. Meta-analysis showed no overall association of cesarean delivery with cerebral palsy (odds ratio [OR] 1.29; 95% confidence interval [CI] 0.92–1.79; 3,810 case group participants and 1,692,580 control group participants). Emergency cesarean delivery was associated with increased risk of cerebral palsy (OR 2.17; 95% CI 1.58–2.98), whereas there was no significant association between elective cesarean delivery and cerebral palsy (OR 0.81; 95% CI 0.41–1.58). Any type of cesarean delivery (elective or emergency) for term newborns was associated with cerebral palsy (OR 1.6; 95% CI 1.05–2.44), whereas there was no association between any type of cesarean delivery and cerebral palsy in preterm newborns (OR 0.81; 95% CI 0.47–1.40). Cesarean delivery did not significantly modify cerebral palsy risk for breech-presenting newborns (OR 0.51; 95% CI 0.13–2.05).
Keywords: Humans; Cerebral Palsy; Pregnancy Complications; Breech Presentation; Emergencies; Cesarean Section; Surgical Procedures, Elective; Risk Factors; Pregnancy; Female
Rights: Copyright © American College of Obstetricians and Gynecologists
RMID: 0020132462
DOI: 10.1097/AOG.0000000000000020
Appears in Collections:Cerebral Palsy Research Group publications

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