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[Perinatal events and handicaps].
Summary
Assessing pediatric handicap linked to perinatal events is challenging due to undefined criteria and multifactorial causes. While cerebral palsy rates are stable, retinopathy of prematurity is increasing, especially in very low birth weight infants.
Area of Science:
- Pediatric neurology
- Neonatology
- Developmental pediatrics
Context:
- Assessing the proportion of pediatric handicap related to perinatal events is complex.
- Lack of uniform criteria for defining 'handicap' and 'perinatal period' complicates assessment.
- Multifactorial origins of impairments and variable perinatal factor involvement hinder accurate correlation.
Purpose:
- To explore the challenges in assessing and tracking handicaps of perinatal origin.
- To identify key clinical conditions associated with perinatal events.
- To discuss the relationship between perinatal care, neonatal survival, and handicap incidence.
Summary:
- Cerebral palsy (CP) incidence remains stable, despite improved perinatal care and decreased neonatal mortality.
- Retinopathy of prematurity (ROP) is experiencing an epidemic, linked to increased survival of extremely low birth weight infants (<1000 gm).
- Perinatal asphyxia, neonatal convulsions, and intraventricular hemorrhage are significant risk markers for sequelae, though underlying causes are often unknown.
Impact:
- Highlights difficulties in establishing direct correlations between perinatal care and handicap outcomes.
- Emphasizes the need for preventative strategies, including preterm birth prevention and regionalized care.
- Underscores the importance of continuous evaluation of interventions and outcomes in perinatal care.