title: Cerebral palsy among children born moderately and late preterm.
abstract: OBJECTIVE
  To compare the incidence of and risk factors for cerebral palsy (CP) in moderately preterm (MP) (32(+0)-33(+6) weeks) and late preterm (LP) (34(+0)-36(+6) weeks) infants with those in very preterm (VP) (<32(+0) weeks) and term infants (≥37 weeks).
  
  
  METHODS
  The national register study included all live-born infants in Finland from 1991 to 2008. Infants who died before the age of 1 year, had any major congenital anomaly, or had missing data were excluded. A total of 1 018 302 infants were included in the analysis and they were analyzed in 4 subgroups (VP, MP, LP, and term) and 3 time periods (1991-1995, 1996-2001, and 2002-2008).
  
  
  RESULTS
  By the age of 7 years, 2242 children with CP were diagnosed (0.2%). CP incidence was 8.7% in the VP, 2.4% in the MP, 0.6% in the LP, and 0.1% in the term group. The risk of CP was highest in the study period 1991-1995 in all groups. Factors predictive of an increased CP risk in the MP and LP groups included resuscitation at birth (odds ratio 1.60; 95% CI 1.01-2.53 and 1.78; 1.09-2.90), antibiotic treatment during the first hospitalization (1.63; 1.08-2.45 and 1.67; 1.13-2.44), 1-minute Apgar score <7 (1.70; 1.15-2.52 and 1.80; 1.21-2.67) and intracranial hemorrhage (7.18; 3.60-14.3 and 12.8; 5.58-29.2).
  
  
  CONCLUSIONS
  The incidence of CP is higher in LP and MP infants compared with term infants. There is a nonlinear decrease in incidence over time and with increasing gestational age.
authors.affiliation: Departments of Pediatrics, and Tampere Center for Child Health Research, and Central Finland Health Care District, Jyväskylä, Finland; mikko.hirvonen@ksshp.fi.
authors.forename: Mikko
authors.initials: M
authors.lastname: Hirvonen
authors.affiliation: Departments of Pediatrics, and Tampere Center for Child Health Research, and.
authors.forename: Riitta
authors.initials: R
authors.lastname: Ojala
authors.affiliation: Departments of Pediatrics, and Tampere Center for Child Health Research, and.
authors.forename: Päivi
authors.initials: P
authors.lastname: Korhonen
authors.affiliation: Departments of Pediatrics, and Tampere Center for Child Health Research, and.
authors.forename: Paula
authors.initials: P
authors.lastname: Haataja
authors.affiliation: Tampere Center for Child Health Research, and Pediatric Neurology, Tampere University Hospital, Tampere, Finland;
authors.forename: Kai
authors.initials: K
authors.lastname: Eriksson
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland; Nordic School of Public Health, Gothenburg, Sweden; and.
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.affiliation: Science Center, Pirkanmaa Hospital District, Tampere, Finland School of Health Sciences, University of Tampere, Tampere, Finland;
authors.forename: Tiina
authors.initials: T
authors.lastname: Luukkaala
authors.affiliation: Departments of Pediatrics, and Tampere Center for Child Health Research, and.
authors.forename: Outi
authors.initials: O
authors.lastname: Tammela
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D001034:Apgar Score; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D017711:Nonlinear Dynamics; D012042:Registries; D012151:Resuscitation; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: cerebral palsy; infant; late preterm; moderately preterm; preterm