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Published on: November 20, 2015
Congenital Malformations in Children With Cerebral Palsy: Is Prematurity Protective?
Marcel Sévère1, Pamela Ng2, Carmen Messerlian3
1Department of Pediatrics, McGill University, Montreal, Quebec City, Canada.
Insights
Congenital malformations affect 23% of children with cerebral palsy (CP). These malformations, particularly brain abnormalities, are more common in term-born children, suggesting a different cause than prematurity-related CP.
Area of Science:
- Neurology
- Pediatrics
- Medical Genetics
Background:
- Congenital malformations are frequently observed in premature infants.
- Prematurity is the primary risk factor for cerebral palsy (CP).
- Understanding malformation profiles in CP is crucial for identifying distinct etiological pathways.
Purpose of the Study:
- To characterize congenital malformations in a Canadian cohort of children with CP.
- To compare malformation profiles between term-born and premature children with CP.
- To investigate the association between congenital malformations, prematurity, and CP subtypes.
Main Methods:
- Retrospective cohort study using the Canadian Cerebral Palsy Registry.
- Comparison of demographic and clinical data using Pearson's chi-square and Student t-tests.
- Calculation of odds ratios and 95% confidence intervals to assess associations.
Main Results:
- Congenital malformations were identified in 23% of participants.
- Brain malformations were most common in term-born children; heart and gastrointestinal malformations were more frequent in premature infants.
- Children with malformations had increased odds of term birth, specific CP types (hypotonic, ataxic, dyskinetic), nonambulatory status, and comorbidities.
Conclusions:
- Approximately 25% of children with CP have associated congenital malformations.
- The distinct profile of term birth, higher Apgar scores, and fewer perinatal seizures in malformed children suggests a separate causal pathway.
- Congenital malformations represent a significant subgroup of cerebral palsy with unique characteristics.
Background:
Congenital malformations are more common in children who are born prematurely, and prematurity is the leading risk factor for cerebral palsy. The primary objective of this study was to describe the profile of congenital malformations in a Canadian cohort of children with cerebral palsy. The secondary objectives were to compare the profiles of children with cerebral palsy with and without a congenital malformation and explore the possible role of prematurity.
Methods:
This retrospective cohort study utilized data from the Canadian Cerebral Palsy Registry, a population based registry of children with a confirmed diagnosis of cerebral palsy. Differences between groups were compared using Pearson's chi-square and Student t test as appropriate. Odds ratios and 95% confidence intervals were calculated RESULTS: Congenital malformations were present in 23% participants. In term-born children, brain malformations were the most common, whereas heart and gastrointestinal malformations were more common in children born prematurely. Children with a malformation had higher odds of being born at term (odds ratio 1.57, 95% confidence interval 1.20 to 2.04); having hypotonic, ataxic, or dyskinetic cerebral palsy (odds ratio 1.92, 95% confidence interval 1.35 to 2.72; being nonambulatory (odds ratio 1.70, 95% confidence interval 1.29 to 2.25); and having cerebral palsy-associated comorbidities.
Conclusions:
One in four children with cerebral palsy have an associated congenital malformation. Their profile of term birth, higher Apgar scores, and lower frequency of perinatal seizures suggests a distinct causal pathway.
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