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Very low birthweight and subsequent neurological defect (with special reference to spastic diplegia)
Insights
This study found a decrease in spastic diplegia among infants weighing 1500g or less, from 10.3% in 1961-64 to 0% in 1965-70. Lower initial body temperature was linked to this neurological condition.
Area of Science:
- Neonatal care
- Pediatric neurology
- Perinatal epidemiology
Background:
- Low birth weight infants (≤1500g) are at increased risk for neurological handicaps.
- Spastic diplegia is a significant neurological impairment affecting motor function.
Purpose of the Study:
- To determine the incidence of neurological handicap, specifically spastic diplegia, in a cohort of low birth weight infants.
- To investigate changes in spastic diplegia incidence over time and identify associated perinatal factors.
Main Methods:
- Longitudinal follow-up of 165 infants born between 1961-1970 at Hammersmith Hospital, London, weighing ≤1500g at birth.
- Statistical analysis to compare incidence rates between 1961-1964 and 1965-1970.
- Analysis of perinatal factors, including rectal temperature, in relation to spastic diplegia.
Main Results:
- Six cases of spastic diplegia were identified (3.6% incidence).
- All cases occurred in infants born between 1961-1964, yielding an incidence of 10.3% for that period.
- No cases of spastic diplegia were observed in infants born between 1965-1970 (0% incidence), a statistically significant difference (p=0.0032).
- A lower mean minimum rectal temperature on the first day of life was the only significant difference observed between infants with and without spastic diplegia in the earlier period.
Conclusions:
- The incidence of spastic diplegia in very low birth weight infants significantly decreased between 1961-1964 and 1965-1970.
- Improved perinatal care or management may have contributed to this decline.
- Hypothermia on the first day of life may be a risk factor for developing spastic diplegia in this population.
Abstract:
Of a total of 170 children who weighed 1500g or less at birth and who were born in or admitted shortly after birth to Hammersmith Hospital, London, between the years 1961-70 inclusive, 165 have been followed to ascertain the incidence of neurological handicap, with particular reference to spastic diplegia. This condition occurred in six children (3-6 per cent), all of whom were born during the 1961-64 period, an incidence in those years of 10-3 per cent, compared with 0-0 per cent in the period 1965-70 (times 2 equal to 8-72, p equal to 0-0032). These findings are considered in the context of perinatal illness and care. The one statistically significant difference found between the children with and without spastic diplegia in the earlier period was a somewhat lower mean minimum rectal temperature on the first day of life only.