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Cerebral palsy: phenotypes and risk factors in term singletons born small for gestational age

Gabrielle Freire1, Michael Shevell2, Maryam Oskoui2

  • 1Department of Pediatrics, CHU Ste-Justine, McGill University, Canada.

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|January 18, 2015
PubMed

Insights

Children born small for gestational age (SGA) with cerebral palsy (CP) exhibit distinct clinical profiles, suggesting antenatal and perinatal causes. These findings highlight differences in motor, communication, and cognitive impairments in SGA-born children with CP.

Area of Science:

  • Pediatric Neurology
  • Developmental Pediatrics
  • Obstetrics

Background:

  • Children born small for gestational age (SGA) face increased risks for cerebral palsy (CP).
  • The underlying pathophysiology linking SGA and CP remains incompletely understood.
  • Identifying distinct clinical profiles in CP cases born SGA is crucial for understanding etiology.

Purpose of the Study:

  • To compare the clinical characteristics of children with CP born SGA against those born at appropriate size.
  • To investigate potential antenatal and perinatal factors contributing to CP in SGA infants.
  • To support the hypothesis of specific etiological pathways for CP in the SGA population.

Main Methods:

  • Retrospective cohort study utilizing data from the Canadian Cerebral Palsy Registry.
  • Inclusion criteria: term singletons diagnosed with CP.
  • SGA definition: birth weight below the tenth percentile for gestational age and sex.

Main Results:

  • Mothers of children with CP born SGA were more likely to have African-American ethnicity, intrauterine infections, and gestational hypertension.
  • Children with CP born SGA presented with smaller head circumferences, higher rates of emergency C-sections, birth asphyxia, and placental abnormalities.
  • Greater impairments in fine motor, gross motor, communication, and cognitive function were observed in children with CP born SGA.

Conclusions:

  • Children with CP born SGA possess distinct clinical and phenotypic profiles compared to their non-SGA counterparts.
  • These differences support the role of antenatal and perinatal factors in the development of CP among SGA infants.
  • Further case-control studies are recommended to elucidate the causal pathways.
Abstract

Keywords:
Cerebral palsyIntra-uterine growth restriction

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