Role of thrombophilic risk factors in children with non-stroke cerebral palsy.
BACKGROUND
Thrombophilic risk factors play an important role in the pathogenesis of perinatal stroke and resultant cerebral palsy (CP). The association between thrombophilia and CP caused by etiologies other than stroke is undetermined.


METHODS
We assessed three genetic thrombophilic markers (mutation of Factor V Leiden [FV G1691A], 677T polymorphism of thermolabile methylenetetrahydrofolate reductase [MTHFR] and G20210A mutation of the prothrombin gene) in 49 pediatric patients with non-stroke CP and compared the findings with 118 apparently healthy controls. CP in the study group was due to periventricular leukomalacia (n=27), intraventricular hemorrhage (n=9), hypoxic ischemic encephalopathy (n=4), prematurity with no apparent complication (n=8) and intrauterine growth retardation (n=1). Twenty-five children had spastic diplegia, 20 had spastic quadriplegia and 4 had spastic hemiplegia. CP was graded as being severe in 26 children (53%).


RESULTS
No significant difference in the prevalence of thrombophilic risk factors was found between the study and control groups. Twelve study children (24.5%) had at least one of the three thrombophilic mutations compared with 27 controls (23%). There was no significant difference in the prevalence of each thrombophilic risk factor in the various etiologic groups and in the subgroups of mild/severe CP and the control group.


CONCLUSIONS
These findings support the notion that thrombophilia neither contributes to the occurrence nor affects the clinical outcome and severity of non-stroke CP.
Fattal-Valevski
Aviva
A
The Institute for Child Development and Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Beit Habriut Strauss, 14 Balfour St., Tel Aviv 65211, Israel. afatal@post.tau.ac.il
Kenet
Gili
G
Kupferminc
Michael J
MJ
Mesterman
Ronit
R
Leitner
Yael
Y
Rimon
Eli
E
Harel
Shaul
S
Hassner
Avi
A
D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000209:etiology* / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D005165:Factor V; D005260:Female; D005820:Genetic Testing; D006801:Humans; D007223:Infant; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D011110:Polymorphism, Genetic; D015995:Prevalence; D011516:Prothrombin / Q000235:genetics; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications*
C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin; D042965:Methylenetetrahydrofolate Reductase (NADPH2)