{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:09:57Z","timestamp":1785499797564,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T00:00:00Z","timestamp":1644710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the association between hypoxic\u2010ischaemic insult timing and brain injury type in infants with severe cerebral palsy (CP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Longitudinal study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Database of the Recurrence Prevention Committee, Japan Obstetric Compensation System for Cerebral Palsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Infants with severe CP born at \u226534\u00a0weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The intrapartum fetal heart rate (FHR) strips were categorised as continuous bradycardia; persistently non\u2010reassuring (NR\u2010NR); reassuring\u2010prolonged deceleration (R\u2010PD); Hon's pattern (R\u2010Hon); persistently reassuring (R\u2010R); and unclassified. The brain magnetic resonance imaging (MRI) scans were categorised based on the predominant site involved: basal ganglia\u2010thalamus (BGT); white matter (WM); watershed (WS); stroke; normal; and unclassified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Manifestations of the brain MRI types and the association between FHR evolution pattern and MRI type were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 672 eligible infants, 76% had BGT\u2010dominant injury, 5.4% WM, 1.2% WS, 1.6% stroke, 1.9% normal, and 14% unclassified. Placental abruption and small\u2010for\u2010gestational age were associated with an increased (adjusted odds ratio [aOR] 8.02) and decreased (aOR 0.38) risk of BGT injury, respectively. The majority of infants had BGT injury in most FHR groups (bradycardia, 97%; NR\u2010NR, 75%; R\u2010PD, 90%; R\u2010Hon, 76%; and R\u2010R, 45%). The risk profiles in case of BGT in the NR\u2010NR group were similar to those in the R\u2010PD and R\u2010Hon groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BGT\u2010dominant brain damage accounted for three\u2010fourths of the cases of CP in term or near\u2010term infants, even in prenatal onset cases. Hypoxic\u2010ischaemic insult has a major impact on CP development during the antenatal period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Basal ganglia\u2010thalamus injury constitutes 76% of severe cerebral palsy cases, predominant even in antenatal\u2010onset cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17089","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T18:09:44Z","timestamp":1641838184000},"page":"1574-1582","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Correlation between fetal heart rate evolution patterns and magnetic resonance imaging findings in severe cerebral palsy: A\u00a0longitudinal study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1137-027X","authenticated-orcid":false,"given":"Masahiro","family":"Nakao","sequence":"first","affiliation":[{"name":"The Recurrence 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