title: Children born at 32 to 35 weeks with birth asphyxia and later cerebral palsy are different from those born after 35 weeks.
abstract: The objectives of this study were to (1) establish the proportion of cerebral palsy (CP) that occurs with a history suggestive of birth asphyxia in children born at 32 to 35 weeks and (2) evaluate their characteristics in comparison with children with CP born at ⩾36 weeks with such a history.
  
  
  
  Using the Canadian CP Registry, children born at 32 to 35 weeks of gestation with CP with a history suggestive of birth asphyxia were compared with corresponding ⩾36 weeks of gestation children.
  
  
  
  Of the 163 children with CP born at 32 to 35 weeks and 738 born at ⩾36 weeks, 26 (16%) and 105 (14%) had a history suggestive of birth asphyxia, respectively. The children born at 32 to 35 weeks had more frequent abruptio placenta (35% vs 12%; odds ratio (OR) 4.1, 95% confidence interval (CI) 1.5 to 11.2), less frequent neonatal seizures (35% vs 72%; OR 0.20, 95% CI 0.08 to 0.52), more frequent white matter injury (47% vs 17%; OR 4.3, 95% CI 1.3 to 14.0), more frequent intraventricular hemorrhage (IVH) (40% vs 6%; OR 11.2, 95% CI 3.4 to 37.4) and more frequent spastic diplegia (24% vs 8%; OR 1.8, 95% CI 1.2 to 12.2) than the corresponding ⩾36 weeks of gestation children.
  
  
  
  Approximately 1 in 7 children with CP born at 32 to 35 weeks had a history suggestive of birth asphyxia. They had different magnetic resonance imaging patterns of injury from those born at ⩾36 weeks and a higher frequency of IVH. Importantly, when considering hypothermia in preterm neonates with suspected birth asphyxia, prospective surveillance for IVH will be essential.
authors.affiliation: Department of Pediatrics, McGill University, Montreal, QC, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Garfinkle
authors.affiliation: Department of Pediatrics, McGill University, Montreal, QC, Canada.|Division of Newborn Medicine, McGill University Health Center, Montreal, QC, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Wintermark
authors.affiliation: Department of Pediatrics, McGill University, Montreal, QC, Canada.|Department of Neurology/Neurosurgery, McGill University, Montreal, QC, Canada.|Division of Pediatric Neurology, McGill University Health Centre, Montreal, QC, Canada.
authors.forename: M I
authors.initials: MI
authors.lastname: Shevell
authors.affiliation: Departments of Pediatrics and Neurology and Neurosurgery, McGill University, Montréal, QC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Oskoui
mesh_terms: D001238:Asphyxia Neonatorum / Q000175:diagnosis / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D000074042:Cerebral Intraventricular Hemorrhage / Q000175:diagnosis / Q000453:epidemiology; D002547:Cerebral Palsy / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011247:Pregnancy; D047928:Premature Birth; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D013223:Statistics as Topic