Children with cerebral palsy and periventricular white matter injury: does gestational age affect functional outcome?

Area of Science:

• Neurology
• Pediatrics
• Developmental Pediatrics

Background:

• Cerebral palsy (CP) and periventricular white matter injury (PWMI) are common in preterm infants.
• Gestational age at birth is a significant factor influencing CP outcomes.
• Understanding functional differences based on prematurity is crucial for targeted interventions.

Purpose of the Study:

• To compare functional profiles and movement disorder patterns in children with CP and PWMI based on gestational age at birth.
• To identify specific areas of functional difference between children born >34 weeks gestation and those born ≤34 weeks gestation.

Main Methods:

• A cohort of children aged 4-12 years with CP and PWMI was recruited.
• Functional status was assessed using the Gross Motor Function Classification System (GMFCS), Manual Abilities Classification System (MACS), Communication Function Classification System (CFCS), Functional Mobility Scale (FMS), and Bimanual Fine Motor Function (BFMF).
• Movement disorder topography was classified using the Surveillance of Cerebral Palsy in Europe (SCPE) criteria.

Main Results:

• Children born >34 weeks gestation demonstrated significantly milder impairments in GMFCS, FMS, MACS, and CFCS compared to those born ≤34 weeks gestation.
• Specifically, the >34 weeks group exhibited less severe limitations in gross motor function, mobility, manual ability, and communication.
• Statistical analysis revealed significant differences between the groups for key functional measures (p<0.05).

Conclusions:

• Children with CP and PWMI born later (>34 weeks gestation) experience milder functional deficits.
• Gestational age is a critical determinant of functional outcomes in children with CP and PWMI.
• These findings highlight the importance of considering gestational age in the management and prognosis of pediatric CP.