Risk factors of cerebral palsy in preterm infants.
OBJECTIVE
To investigate the outcome of preterm infants and to determine the most important risk factors in the development of cerebral palsy.


METHODS
The outcomes of 437 survivors of preterm infancy (gestational age at birth, <36 wk) born in one center in Korea were reviewed in relation to the clinical risk factors in the perinatal period and neonatal cerebral ultrasound lesions that occurred over a 3-yr period. The odds ratios of risk factors for the development of cerebral palsy were calculated.


RESULTS
A total of 4.8% of all survivors subsequently developed cerebral palsy. The prevalence of cerebral palsy was 12% in infants that weighed <2000 g at birth, but it was only 0.4% in those that weighed >2000 g. Preterm labor, preterm rupture of membrane, severe birth asphyxia, neonatal sepsis, and respiratory distress syndrome had stronger correlations with the development of cerebral palsy. A total of 56% of infants having periventricular leukomalacia and 53% of those having grade 3 intraventricular hemorrhage developed cerebral palsy. The infants with cystic lesions had higher rates of the quadriplegic type and were more severely disabled.


CONCLUSIONS
The existence of periventricular leukomalacia was the strongest and most independent risk factor for the subsequent development of cerebral palsy. The grade of periventricular leukomalacia was significantly correlated with the clinical type and severity of cerebral palsy.
Han
Tai Ryoon
TR
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Bang
Moon Suk
MS
Lim
Jae Young
JY
Yoon
Bo Hyeon
BH
Kim
In Won
IW
D000328:Adult; D001724:Birth Weight; D002547:Cerebral Palsy / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007723:Korea / Q000453:epidemiology; D007969:Leukomalacia, Periventricular / Q000150:complications / Q000000981:diagnostic imaging; D008423:Maternal Age; D015999:Multivariate Analysis; D015997:Neonatal Screening; D007744:Obstetric Labor Complications; D011247:Pregnancy; D015995:Prevalence; D012306:Risk; D018709:Statistics, Nonparametric; D014463:Ultrasonography