ANALYSIS OF ETIOLOGIC FACTORS IN CEREBRAL-PALSY WITH SEVERE MENTAL-RETARDATION .1. ANALYSIS OF GESTATIONAL, PARTURITIONAL AND NEONATAL DATA

The gestational, parturitional, neonatal (GPN) histories of 281 severely mentally retarded patients with cerebral palsy were analyzed to define the etiology or pathogenesis of cerebral palsy in each patient. No association between type of cerebral palsy and GPN histories was found except for an increase in spastic-athetoid patients in the breech delivery subgroup. Significant findings include: increased incidence of prematurity and postmaturity, small and large for-gestational age (GA) fetal size, a normal birthweight for GA distribution of patients with diabetic mothers, an excess of mothers .gtoreq. 35 and .ltoreq. 20 yr old, an increased immediately-previous sib interval of 2.59 yr suggestive of an "infertility factor", an unremarkable GPN history in 1/3 of the cases, in another 1/3 GPN problems not usually associated with a high risk of CNS damage, and in 1/3 gross complications which were probably responsible for the CP, including: an increased incidence of breech deliveries, twinning, prolonged and precipitous labor and placental complications; no increased association of athetosis and Rh incompatibility or incidence of toxemia was found. Disseminated intravascular coagulation due to prenatal death of a twin may have been the cause of brain damage in several patients.