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[Infantile cerebral palsy and neuromotor development in very low birth weight infants]
E Fazzi1, L Bianchini, A Ometto
1Divisione e Cattedra di Neuropsichiatria Infantile, IRCCS Fondazione C. Mondino Università di Pavia.
Insights
Cerebral palsy (CP) affected 15.7% of high-risk infants at 12-24 months, with rates declining over time. Neuromotor development correlated with perinatal factors like birth type and respiratory distress.
Area of Science:
- Neonatology
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Intensive neonatal care is crucial for high-risk infants.
- Assessing long-term neurodevelopmental outcomes is essential for this population.
- Cerebral palsy (CP) is a significant concern in preterm and low birth weight infants.
Purpose of the Study:
- To evaluate the incidence of cerebral palsy (CP) in infants born between 1980-1985 who received intensive neonatal care.
- To assess the neuromotor and cognitive development of these children up to 36 months corrected age.
- To identify perinatal factors associated with neuromotor development in this cohort.
Main Methods:
- A longitudinal follow-up study of 127 infants weighing ≤1500g at birth.
- Neuromotor and cognitive development assessed at 12, 24, and 36 months corrected age.
- Statistical analysis to determine correlations between perinatal factors and neurodevelopmental outcomes.
Main Results:
- The incidence of CP was 15.7% at 12 and 24 months, and 14.6% at 36 months.
- A peak in CP rates was noted for infants born in 1982, with a subsequent decline.
- Infants with very low birth weight (1001-1500g) had a higher CP incidence than extremely low birth weight infants (≤1000g).
- Significant correlations were found between neuromotor development and birth type, sex, respiratory distress, acidosis, ultrasound findings, and neurological examination at 40 weeks gestational age.
Conclusions:
- The study highlights the persistent challenge of CP in infants requiring intensive neonatal care.
- A decreasing trend in CP incidence suggests improvements in neonatal care over the study period.
- Perinatal factors play a critical role in the neuromotor development of high-risk infants, emphasizing the need for targeted interventions.
Abstract:
One hundred twenty-seven children born between September 1st 1980 and August 31st 1985 weighing less than or equal to 1500 g at birth and submitted to intensive neonatal care were followed-up to the age of 12-36 months of corrected age with a follow-up program to assess their neuromotor and cognitive development. The incidence of cerebral palsy (CP) in the population in question was 15.7% at 12 and 24 months and 14.6% at 36 months. A peak CP rate was observed among those born in 1982 with a steady decline in the number of CP cases among those born in the last years of this study. The group of children with a birth weight of 1001-1500 g (VLBWI) was more heavily affected by CP than those whose weight was less than or equal to 1000 g (ELBWI). Statistical analysis revealed a significant correlation between neuromotor development and the following factors relative to the perinatal period: type of birth, sex, respiratory distress requiring assisted ventilation, acidosis, ultrasound, neurological examination at the 40th week of gestational age.