title: Characteristics of children with cerebral palsy in the ORACLE children study.
abstract: OBJECTIVE
  We have identified an excess of children with cerebral palsy (CP) born to women who received antibiotic treatment for spontaneous preterm labour (SPL). This nested study investigated the profile of impairment among children with CP in the ORACLE Children Study (OCS), and contrasted outcomes with those in 4Child, a population CP registry.
  
  
  METHODS
  The study group comprised 167 children aged from 7 to 10 years (100 males, 67 females) with CP from the OCS, who were subdivided into a preterm rupture of membranes (PROM) group (87 children) and an SPL group (80 children). The OCS sought follow-up information regarding the health and behaviour of surviving children at 7 years of age in the UK using a parent-report postal questionnaire. Families provided further information to define wider aspects of function and were offered a physiotherapy assessment.
  
  
  RESULTS
  The prevalence of CP was higher among children in the OCS than among those in 4Child (standardized morbidity ratios: SPL group, 3.12 [95% confidence interval {CI} 2.47-3.87); PROM group: 1.56 (CI 1.24-1.92)]. The proportion of children with CP born after 32 weeks of gestation was higher in in the SPL group (73%) than in the PROM group (30%); the prevalence of CP was higher in the SPL group than in the PROM group or 4Child. Children with CP in the OCS tended to have similar distributions of neuroimpairment as children in 4Child, but motor impairment and associated vision and hearing problems were found to be less severe.
  
  
  CONCLUSIONS
  The pattern of CP in both the PROM and the SPL groups was similar, but functional outcomes were milder, compared with children with CP in the general population. However, in these groups the risk of CP was increased independently of gestational age. This is consistent with findings that ongoing inflammatory damage can cause CP.
authors.affiliation: Institute for Women's Health, University College London, London, UK. n.marlow@ucl.ac.uk
authors.forename: Neil
authors.initials: N
authors.lastname: Marlow
authors.forename: Katie
authors.initials: K
authors.lastname: Pike
authors.forename: Eva
authors.initials: E
authors.lastname: Bower
authors.forename: Peter
authors.initials: P
authors.lastname: Brocklehurst
authors.forename: David
authors.initials: D
authors.lastname: Jones
authors.forename: Sara
authors.initials: S
authors.lastname: Kenyon
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Kurinczuk
authors.forename: David
authors.initials: D
authors.lastname: Taylor
authors.forename: Alison
authors.initials: A
authors.lastname: Salt
mesh_terms: D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D001724:Birth Weight; D002547:Cerebral Palsy / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D002648:Child; D004522:Educational Status; D004917:Erythromycin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006801:Humans; D008297:Male; D009017:Morbidity; D009035:Mothers / Q000706:statistics & numerical data; D009069:Movement Disorders / Q000209:etiology; D009099:Multiple Birth Offspring; D007752:Obstetric Labor, Premature; D011203:Poverty; D011247:Pregnancy; D047928:Premature Birth; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents; D004917:Erythromycin; D019980:Amoxicillin-Potassium Clavulanate Combination