Cerebral palsy: Phenotypes and risk factors in term singletons born small for gestational age

被引:24
|
作者
Freire, Gabrielle [1 ]
Shevell, Michael [2 ,3 ]
Oskoui, Maryam [2 ,3 ]
机构
[1] McGill Univ, CHU Ste Justine, Dept Pediat, Montreal, PQ H3A 2T5, Canada
[2] McGill Univ, Dept Pediat, Montreal, PQ H3A 2T5, Canada
[3] McGill Univ, Dept Neurol & Neurosurg, Montreal, PQ, Canada
关键词
Cerebral palsy; Intra-uterine growth restriction; WEIGHT PERCENTILE CURVES; INTRAUTERINE GROWTH; NEWBORN ENCEPHALOPATHY; BIRTH-WEIGHT; METAANALYSIS; DELIVERIES; PREVALENCE; ASPHYXIA;
D O I
10.1016/j.ejpn.2014.12.005
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and objectives: Children born small for gestational age (SGA) are at increased risk of developing cerebral palsy (CP). The pathophysiology behind this association remains unclear. We compare the clinical profile of children with CP born SGA to other children with CP. We hypothesize that differences noted will support antenatal causes of CP in children born SGA. Methods: We conducted a retrospective cohort study of term singletons with CP, extracting data from the Canadian Cerebral Palsy Registry. SGA was determined as birth weight for gestational age and sex below the tenth percentile. Results: Mothers of children with CP born SGA were more likely to be of African-American ethnicity (RR 2.54, 95% CI 1.20-5.39), have intrauterine infections (RR 2.22, 95% CI 1.09-4.50) and have gestational hypertension (RR 1.78, 95% CI 1.06-3.00). Children with CP born SGA had smaller head circumferences at birth (p < 0.001) and higher frequencies of emergency cesarean-section (RR 1.53, 95% CI 1.22-1.92), birth asphyxia (RR 1.53, 95% CI 1.0-2.32), and placental abnormalities (RR 1.45, 95% CI 1.00-2.10). Children with CP born SGA had greater fine motor (RR 1.46, 95% CI 1.02-2.11), gross motor (RR 1.53, 95% CI 1.12-2.10) and communication impairment (RR 1.24, 95% CI 1.10-1.40), and a higher frequency of cognitive impairment (RR 1.33, 95% CI 1.06-1.69). Conclusion: Children with CP born SGA have different clinical factors and phenotypic profiles than other children with CP. These differences support the hypothesis of antenatal and perinatal causes of CP in children born SGA. Future case control studies would be desired to further define this causal pathway. (C) 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:218 / 225
页数:8
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