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Risk factors of cerebral palsy in preterm infants
Tai Ryoon Han1, Moon Suk Bang, Jae Young Lim
1Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Insights
Periventricular leukomalacia is the strongest predictor of cerebral palsy in preterm infants. Its severity correlates with the type and disability level of cerebral palsy, highlighting its critical role in infant outcomes.
Area of Science:
- Neonatal neurology
- Pediatric neurology
- Developmental pediatrics
Background:
- Cerebral palsy (CP) is a significant concern in preterm infants.
- Identifying risk factors is crucial for early intervention and improved outcomes.
Purpose of the Study:
- To investigate the outcomes of preterm infants.
- To determine the most critical risk factors for cerebral palsy development.
Main Methods:
- Retrospective review of 437 preterm infants (<36 weeks gestational age).
- Analysis of perinatal clinical risk factors and neonatal cerebral ultrasound findings.
- Calculation of odds ratios for cerebral palsy risk factors.
Main Results:
- 4.8% of survivors developed cerebral palsy.
- Infants <2000g birth weight had a 12% prevalence of CP vs. 0.4% for >2000g.
- Periventricular leukomalacia (PVL) and Grade 3 intraventricular hemorrhage were strongly associated with CP.
- Cystic lesions on ultrasound correlated with more severe CP types and disability.
Conclusions:
- Periventricular leukomalacia is the most significant independent risk factor for cerebral palsy in preterm infants.
- The grade of PVL directly correlates with the clinical type and severity of cerebral palsy.
Objective:
To investigate the outcome of preterm infants and to determine the most important risk factors in the development of cerebral palsy.
Design:
The outcomes of 437 survivors of preterm infancy (gestational age at birth, <36 wk) born in one center in Korea were reviewed in relation to the clinical risk factors in the perinatal period and neonatal cerebral ultrasound lesions that occurred over a 3-yr period. The odds ratios of risk factors for the development of cerebral palsy were calculated.
Results:
A total of 4.8% of all survivors subsequently developed cerebral palsy. The prevalence of cerebral palsy was 12% in infants that weighed <2000 g at birth, but it was only 0.4% in those that weighed >2000 g. Preterm labor, preterm rupture of membrane, severe birth asphyxia, neonatal sepsis, and respiratory distress syndrome had stronger correlations with the development of cerebral palsy. A total of 56% of infants having periventricular leukomalacia and 53% of those having grade 3 intraventricular hemorrhage developed cerebral palsy. The infants with cystic lesions had higher rates of the quadriplegic type and were more severely disabled.
Conclusion:
The existence of periventricular leukomalacia was the strongest and most independent risk factor for the subsequent development of cerebral palsy. The grade of periventricular leukomalacia was significantly correlated with the clinical type and severity of cerebral palsy.