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Published on: November 20, 2015
The epidemiology of cerebral palsy in term infants
1Neuroepidemiology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1447, USA. knelson@helix.nih.gov
Insights
Half of cerebral palsy (CP) cases occur in full-term infants, with no recent decrease in prevalence. Risk factors like infection and coagulation disorders are implicated, but interventions are unproven.
Area of Science:
- Neurology
- Pediatrics
- Obstetrics
Background:
- Cerebral palsy (CP) affects many infants of normal birthweight, yet research often focuses on premature infants.
- The prevalence of CP in term and near-term infants has not decreased in recent decades.
- Birth complications related to oxygen deprivation cause a small fraction of CP cases.
Purpose of the Study:
- To review current understanding of CP risk factors in term and near-term infants.
- To highlight emerging associations with coagulation disorders and intrauterine infection/inflammation.
- To assess the efficacy of current and potential interventions.
Main Methods:
- Review of recent scientific literature on cerebral palsy risk factors.
- Analysis of associations between neonatal encephalopathy and CP in term infants.
- Evaluation of evidence for therapeutic interventions.
Main Results:
- Disorders of coagulation and intrauterine infection/inflammation are linked to CP risk.
- Neonatal encephalopathy is a key predictor of CP in term neonates.
- Interventions for oxygen supply interruption have not reduced CP occurrence.
Conclusions:
- Further research is needed on CP in term infants, focusing on infection and coagulation.
- Medical interventions targeting infection and coagulation disorders require investigation for CP prevention.
- Understanding non-asphyxial causes is crucial for reducing CP rates.
Abstract:
Half of cerebral palsy (CP) arises in infants of normal birthweight; yet, many fewer studies seek to identify risk factors for CP in term and near-term infants than in those born very prematurely. There has been no net decrease in the prevalence of CP in term and near-term infants over recent decades. Potentially asphyxiating birth complications account for a small minority of CP cases. Recent studies suggest that disorders of coagulation and intrauterine exposure to infection or inflammation are associated with risk of CP, and that both can be accompanied by signs of neonatal encephalopathy, the best available predictor of CP in term neonates. Therapeutic interventions directed at preventing interruption of oxygen supply have not been shown to reduce the occurrence of CP. There have not yet been studies examining whether medical interventions directed at infection or coagulation disorder can reduce the frequency of CP.
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