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Cerebral palsy in infants with asymmetric growth restriction
1Department of Obstetrics and Gynecology, University of South Florida, Tampa 33606-3589, USA.
Insights
Low ponderal index, a measure of fetal growth, is linked to a higher risk of cerebral palsy (CP). This association persists even in infants who are not small for gestational age (SGA), highlighting its importance in predicting CP risk.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) is a complex neurodevelopmental disorder.
- Fetal growth abnormalities are suspected contributors to CP development.
- The ponderal index (PI) reflects fetal growth and body composition.
Purpose of the Study:
- To evaluate the association between low ponderal index and cerebral palsy.
- To determine if this association is independent of gestational age and SGA status.
Main Methods:
- Analysis of data from the National Collaborative Perinatal Project and the University of California Child Health and Development Study.
- Inclusion of 55,571 infants, with 232 diagnosed with cerebral palsy.
- Evaluation of low ponderal index (PI < 5% for gestational age) in the overall population, term/preterm infants, and non-SGA infants.
- Logistic regression analysis to adjust for prematurity and gender effects.
Main Results:
- Low ponderal index was significantly associated with CP in the total delivery population (Relative Risk [RR] 2.2).
- A significant association was observed in non-SGA infants (RR 1.9).
- Low ponderal index remained an independent correlate of CP in non-SGA infants after adjustment (RR 1.9).
Conclusions:
- Low ponderal index is associated with an increased risk of cerebral palsy, even in infants who are not small for gestational age.
- Neonatal ponderal index assessment can help identify abnormal fetal growth and development, potentially indicating elevated CP risk.
- This finding suggests PI is a valuable indicator for early identification of infants at risk for CP.
Abstract:
The relationship between low ponderal index and cerebral palsy was evaluated. National Collaborative Perinatal Project and University of California Child Health and Development Study data were analyzed. Associations between low ponderal index (ponderal index < 5% for gestational age) were evaluated in the combined population, in term and preterm infants, and in non-SGA infants (with birth weights > 5% for gestational age and gender). Data from 55,571 infants, including 232 cases of cerebral palsy, were evaluated. Low ponderal index was significantly associated with CP in the delivery population (Relative risk 2.2) and in non-SGA infants (RR 1.9). Low ponderal index was a significant independent correlate of cerebral palsy (RR 1.9) in non-SGA infants after using logistic regression to correct for effects of prematurity and gender. Low ponderal index is associated with increased risk of CP, even in non-SGA infants. Assessment of the neonatal ponderal index provides an additional method of documenting prior abnormal fetal growth and development.