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[Handicaps and the perinatal period. II. Perinatal pathology and severe deficiencies]
B Lacour1, R Cecchi Tenerini, J Fresson
1Inspection régionale de la santé, DRASS de Lorraine, France.
Insights
Major disabilities in children, including cerebral palsy and mental retardation, are linked to perinatal events like prematurity and asphyxia. These factors significantly increase the risk of neurodevelopmental handicaps.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Context:
- Infant mortality has decreased, but neurodevelopmental handicaps may be increasing.
- Improved newborn care may inadvertently lead to higher rates of disabilities.
Purpose:
- To estimate the rate of major childhood disabilities.
- To investigate the relationship between perinatal events and these disabilities.
Summary:
- A study of 316 children born in 1984 found a major disability rate of 3.4/1000 at age 6.
- Preterm birth (OR=4.8), being small for gestational age (OR=3.3), and perinatal asphyxia (OR=32.8) were significantly associated with disabilities.
- These perinatal factors explained 37.4% of major disabilities.
Impact:
- Highlights the crucial link between perinatal events and major handicaps.
- Suggests that antenatal factors also play a role in neurodevelopmental issues.
- Informs strategies for preventing childhood disabilities.
Background:
In the last two decades, the infant mortality rate has dramatically declined. But improved management of newborns may induce an increased prevalence of neurodevelopmental handicaps. The aim of this paper is to estimate the rate of major disabilities and their relationships to perinatal events.
Population And Methods:
Three hundred and sixteen children born in 1984 and registered by the "Commission Départementale de l'Education Spéciale" (CDES) were included in the study. Among these, 97 had either cerebral palsy, blindness, deafness, or mental retardation. These 97 children were compared to 602 school age controls using a multivariate analysis (logistic regression).
Results:
The rate of major disabilities among the 6-year old children is 3.4/1000. It was 5/1000 in 1972 and 4.3/1000 in 1976. This frequency is higher in the children who were preterm (odds ratio--OR = 4.8), small for gestational age (OR = 3.3) or suffered from perinatal asphyxia (OR = 32.8). These three factors accounted for 37.4% of major disabilities.
Conclusion:
This study emphasizes the relationships between perinatal events and some major handicaps but also shows that antenatal factors may be involved in neurodevelopmental problems.