Cesarean delivery and cerebral palsy: A systematic review and meta-analysis

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dc.contributor.authorO'Callaghan, M.
dc.contributor.authorMacLennan, A.
dc.contributor.organisationRobinson Institute
dc.date.issued2013
dc.description.abstractOBJECTIVE: 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).
dc.description.statementofresponsibilityMichael O’Callaghan, and Alastair MacLennan
dc.identifier.citationObstetrics and Gynecology, 2013; 122(6):1169-1175
dc.identifier.doi10.1097/AOG.0000000000000020
dc.identifier.issn0029-7844
dc.identifier.issn1873-233X
dc.identifier.orcidO'Callaghan, M. [0000-0001-5038-5859] [0000-0002-8178-9714]
dc.identifier.urihttp://hdl.handle.net/2440/81036
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.rightsCopyright © American College of Obstetricians and Gynecologists
dc.source.urihttps://doi.org/10.1097/aog.0000000000000020
dc.subjectHumans
dc.subjectCerebral Palsy
dc.subjectPregnancy Complications
dc.subjectBreech Presentation
dc.subjectEmergencies
dc.subjectCesarean Section
dc.subjectRisk Factors
dc.subjectPregnancy
dc.subjectFemale
dc.subjectElective Surgical Procedures
dc.titleCesarean delivery and cerebral palsy: A systematic review and meta-analysis
dc.typeJournal article
pubs.publication-statusPublished

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