Cerebral palsy and restricted growth status at birth: population-based case-control study

Area of Science:

• Perinatal Medicine
• Developmental Neurology
• Pediatric Epidemiology

Background:

• Cerebral palsy (CP) is a complex neurological disorder with multifactorial causes.
• Infant growth status at birth, particularly small for gestational age (SGA), is a potential risk factor for CP.
• Understanding the differential impact of SGA on CP risk in preterm versus term infants is crucial for targeted interventions.

Purpose of the Study:

• To investigate the association between birth growth status and the subsequent development of cerebral palsy.
• To compare this association in preterm (early and late) and term infants.

Main Methods:

• Population-based case-controlled study in Western Sweden.
• Included 334 singletons with CP and 668 matched controls born between 1983-1990.
• Growth status assessed using customized birthweight percentiles (SGAcust), categorizing infants as SGA <1st percentile (SGAcust1) or SGA between 1st-5th percentiles.

Main Results:

• Term infants with SGAcust1 had a 6.6-fold increased risk of CP compared to controls.
• Less severely small term infants (SGA 1st-5th percentiles) showed a 5.2-fold increased risk of CP.
• Preterm infants, both early and late preterm, did not show an increased likelihood of being SGAcust1 or less severely small compared to controls.

Conclusions:

• Severely small for gestational age (SGA) term singletons face a substantially elevated risk of cerebral palsy.
• SGA is not a significant risk factor for cerebral palsy in preterm infants.
• These findings underscore the multifactorial nature of CP and emphasize the importance of monitoring fetal growth during pregnancy.