Prevalence of prematurity, low birthweight, and asphyxia as perinatal risk factors in a current population of children with cerebral palsy.
To test the hypothesis that increasing survival of infants at highest risk for long-term neurological sequelae has strengthened the associations between perinatal events and subsequent cerebral palsy (CP), we compared the prevalence rates for prematurity, low birthweight, congenital malformations, and perinatal asphyxia from a current population of children with CP with those reported nearly 30 years ago by the National Collaborative Perinatal Project (NCPP, 1959-1966) of the National Institute of Neurologic and Communicative Disorders and Stroke. Although we saw no differences in the proportion of children who were born prematurely, we did find a significant shift in the birthweight and gestational age distribution, with a nearly threefold greater prevalence of births less than 1501 g in our population (31.1% and 95% confidence interval [CI] of 20.6 to 41.7% vs 9.1% and 95% CI of 5.0 to 13.2%). Nearly half (43.5%) of these very low birthweight infants had evidence of brain injury (intraventricular hemorrhage), a diagnosis not commonly recognized in the NCPP. On the other hand, birth asphyxia and congenital malformations occurred no more frequently in our population than that reported earlier. Furthermore, the majority (60%) of full-term infants who develop CP continue to be the products of normal pregnancies and have no perinatal events that may have caused their neurological impairment. The increasing prevalence of births less than 1501 g among children with CP may well reflect the improving survival of very small infants over the last 30 years.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Pediatrics, Walter Reed Army Medical Center, Washington, DC.
C M
CM
Naulty
L B
LB
Long
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Pettett
D001238:Asphyxia Neonatorum / Q000150:complications*; D001724:Birth Weight; D002543:Cerebral Hemorrhage / Q000150:complications; D002547:Cerebral Palsy / Q000209:etiology*; D005260:Female; D005311:Fetal Hypoxia / Q000150:complications*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012307:Risk Factors