Abstract T P321: Perinatal Stroke in the Canadian Cerebral Palsy Registry: Disease-Controlled Risk Factor Analysis
Bibliographic record
Abstract
Objective: Perinatal stroke causes most hemiparetic cerebral palsy (CP). Pathophysiology is usually idiopathic with few case-control risk factor studies. Comparisons to related disease states have not been done in perinatal stroke and may provide unique insight. The Canadian CP registry (CCPR) is multi-regional and population-based with imaging results and >70 risk factor variables. We hypothesized that CCPR perinatal stroke could be defined with distinct risk factor profiles within CP populations. Methods: The CCPR enrolls children with CP across 13 Canadian centres. Systematic chart reviews and parental interviews acquire standardized data on >150 variables including risk factors and imaging. Data current to June 2013 was extracted (RedCAP) and analyzed (SPSS). Imaging reports for hemiparetic CP cases were classified as: (1) definitive stroke, (2) probable stroke, (3) not stroke (alternate diagnosis), or (4) inconclusive. Risk factor variables were compared between definitive stroke and two disease control groups: (1) hemiparetic CP, not stroke and (2) all other CP. Univariate analysis (Chi-Square, t-test) informed multivariate logistic regression (associations expressed as odds ratios, 95% confidence intervals). Results: At extraction, 1168 children were enrolled (57% male, median 42±23mos). Hemiparetic was the single most common CP phenotype (323, 28%). Definitive perinatal stroke was common (158, 49%) compared to definitively not stroke (109, 34%). Strokes were arterial (103, 66.6%) or venous (52,33.3%). Comparing stroke to non-stroke hemiparetic CP found seven univariate associations but none persisted on multivariate analysis. Comparing stroke to other CP types, the following factors were independently associated with stroke: preeclampsia (2.35;1.11-4.95;p=0.025), prematurity (0.165;0.093-0.293; p<0.001), maternal drug use (5.03;2.05-12.35;p<0.0001) and possibly male gender (1.47;0.997-2.19;p=0.058). Conclusions: Perinatal stroke can be examined within CP registries. Disease-specific risk factors may include previously (male gender) or inconsistently (preeclampsia) reported associations and novel factors (maternal drugs). Disease-controlled approaches may inform perinatal stroke pathogenesis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.005 | 0.012 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".