AIMS: To examine the effects of multiple risk factors on cerebral palsy (CP). MATERIALS/ METHODS: For 176,591 Norwegian infants born 1996-98 and surviving the early neonatal period, data on a number of potential pre- and perinatal risk factors (RFs) for CP were available in the Medical Birth Registry of Norway. For 241 children with CP detailed clinical data were available in the Norwegian CP registry. RESULTS: In children born at term, 31% had no RF, and none had five or more, while in children born preterm, 9% had no RF in addition to prematurity (p < 0.001 vs. term), and 5% had five or more (p < 0.02 vs. term). In both groups, few children shared the same combination of RFs. Interdependent sequences were more often observed among children born preterm than at term (p < 0.001 vs. term). The most detrimental effect was observed for the combination of maternal disease and low 5-min Apgar score, registered in 11.2% of children with CP. The combination of maternal disease and premature birth had an interaction contrast ratio of 9.25 (CI: 3.56; 14.94), which may be consistent with biological interaction. CONCLUSIONS: The majority of children with CP born at term most likely had an antenatal or single cause, suggesting individual susceptibility to an injury. The majority of children born preterm, had combinations or sequences of antenatal and perinatal risk factors as the most likely cause of CP.
AIMS: To examine the effects of multiple risk factors on cerebral palsy (CP). MATERIALS/ METHODS: For 176,591 Norwegian infants born 1996-98 and surviving the early neonatal period, data on a number of potential pre- and perinatal risk factors (RFs) for CP were available in the Medical Birth Registry of Norway. For 241 children with CP detailed clinical data were available in the Norwegian CP registry. RESULTS: In children born at term, 31% had no RF, and none had five or more, while in children born preterm, 9% had no RF in addition to prematurity (p < 0.001 vs. term), and 5% had five or more (p < 0.02 vs. term). In both groups, few children shared the same combination of RFs. Interdependent sequences were more often observed among children born preterm than at term (p < 0.001 vs. term). The most detrimental effect was observed for the combination of maternal disease and low 5-min Apgar score, registered in 11.2% of children with CP. The combination of maternal disease and premature birth had an interaction contrast ratio of 9.25 (CI: 3.56; 14.94), which may be consistent with biological interaction. CONCLUSIONS: The majority of children with CP born at term most likely had an antenatal or single cause, suggesting individual susceptibility to an injury. The majority of children born preterm, had combinations or sequences of antenatal and perinatal risk factors as the most likely cause of CP.
Authors: Espen Lien; Guro L Andersen; Yongde Bao; Heather Gordish-Dressman; Jon S Skranes; Torstein Vik; James A Blackman Journal: Dev Med Child Neurol Date: 2013-02-05 Impact factor: 5.449
Authors: Hamdy N El-Tallawy; Wafaa Ma Farghaly; Ghaydaa A Shehata; Tarek A Rageh; Nabil A Metwally; Reda Badry; Mohamed Am Sayed; Mohamed Abd El Hamed; Ahmed Abd-Elwarth; Mahmoud R Kandil Journal: Neuropsychiatr Dis Treat Date: 2014-07-08 Impact factor: 2.570
Authors: Donna S Hurley; Theresa Sukal-Moulton; Deborah Gaebler-Spira; Kristin J Krosschell; Larissa Pavone; Akmer Mutlu; Julius Pa Dewald; Michael E Msall Journal: Int J Phys Med Rehabil Date: 2015-03-23