Related Experiment Video
Updated: Jun 13, 2025
Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke
Published on: February 22, 2020
Early Biomarkers in the Prediction of Later Functional Impairment in Preterm Children With Cerebral Palsy
Gabrielle Lambert1, Nafisa Husein2, Darcy Fehlings3
1Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada.
Insights
Predicting functional outcomes in preterm children with cerebral palsy (CP) using early biomarkers is challenging. Only low cord/neonatal pH showed a significant association with severe mobility and feeding issues.
Area of Science:
- Neonatal neurology
- Pediatric neurodevelopment
- Biomarker research
Background:
- Cerebral palsy (CP) affects preterm infants, impacting their functional capabilities.
- Identifying early biomarkers is crucial for predicting long-term outcomes in these children.
Purpose of the Study:
- To identify early objective biomarkers that can predict later functional capabilities in preterm children who develop CP.
- To assess the association between specific early biomarkers and severe mobility impairment (GMFCS IV-V) and feeding dependence.
Main Methods:
- Utilized data from 968 preterm children with CP from the Canadian Cerebral Palsy Registry.
- Performed univariate and chi-square analyses to correlate early biomarkers with GMFCS levels and feeding status.
- Included infants born at various gestational ages (pre-27, 27-33, 34-37 weeks).
Main Results:
- No significant association found between severe CP outcomes (GMFCS IV-V, tube feeding) and MRI-detected white matter injury, intraventricular hemorrhage, chorioamnionitis, low birth weight, or low Apgar scores.
- Gestational age <28 weeks also showed no significant predictive association.
- A significant association was observed between GMFCS IV-V/feeding dependence and a cord or first hour of life pH ≤7 (OR 1.95 for mobility, OR 2.23 for feeding).
Conclusions:
- Predicting functional outcomes in preterm children with CP using early biomarkers is difficult, unlike in term-born children.
- The complex nature of prematurity and its associated complications may hinder definitive prognostication based on early markers.
Background:
To identify early biomarkers that could predict later functional capabilities in preterm children with later cerebral palsy (CP).
Methods:
Data from 968 preterm children with later CP were extracted from the Canadian Cerebral Palsy Registry. One hundred eighty-two infants were born before 27 weeks of gestation, 461 infants were born between 27 and 33 weeks, and 325 infants were born between 34 and 37 weeks. Univariate and chi-square analyses were conducted to measure the association between early objective biomarkers and later mobility status defined as Gross Motor Function Classification System (GMFCS) levels IV and V as well as tube feeding dependence.
Results:
Univariate analysis suggested no significant association between GMFCS levels IV and V or impaired feeding status and bilateral white matter injury on magnetic resonance imaging, high-grade intraventricular hemorrhage on head ultrasound, chorioamnionitis, a birth weight of 1000 to 1500 g or <1000 g, as well as an Apgar score of ≤5 at five minutes of life. Similar results were found for gestational age <28 weeks at birth. Only a significant association between GMFCS levels IV and V and a cord or first hour of life pH of ≤7 was reported (mobility status: odds ratio [OR] 1.95, 95% confidence interval [CI] 1.09 to 3.57) and feeding status: OR 2.23, CI 0.97 to 4.65)].
Conclusions:
Prediction of functional outcomes based on specific early biomarkers appears hard to obtain in children with CP born preterm in contrast to those born at term. The complications and causal pathways inherent to prematurity may contribute to making prognostication less determinant.
