To estimate the proportion of children with cerebral palsy (CP) who had signs of birth asphyxia in the early hours of life, and to examine the nature of the illnesses in those infants.
Population-based case-control study.
All births in 4 northern California counties, 1983 through 1985.
Eighty-four full-term singleton children surviving to age 3 years with spastic CP and 366 full-term control children.
Moderate or severe spastic CP.
Of 84 full-term children with spastic CP, 18 had 5-minute Apgar scores of less than 6,20 required intubation for ventilation in the delivery room, and 5 had an initial blood pH of 7.00 or less.
Three (3.6%) of the 84 children had all 3 signs evaluated, a prevalence of 0.019 per 1000 survivors.
All 3 had neonatal seizures.
When we relaxed the pH cutoff to 7.10 or less, there were 19 children with CP who met at least 2 criteria.
Eight of these 19 infants were born in level I facilities.
In these children there was evidence of maternal or infant infection (n=7) ; abnormal coagulation factor, thrombosis, or thrombocytopenia (n=8) ; or other complication predating birth (n=9).
Neuroprotective therapy offered to neonates with these early characteristics, even if perfectly effective, would be unlikely to prevent most CP.
Most of these depressed infants with CP had nonasphyxial conditions that may have contributed to adverse neurological outcome.
Mots-clés Pascal : Infirmité motrice cérébrale, Détresse respiratoire, Naissance, Néonatal, Facteur risque, Enfant, Homme, Epidémiologie, Californie, Etats Unis, Amérique du Nord, Amérique, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Appareil respiratoire pathologie
Mots-clés Pascal anglais : Cerebral palsy, Respiratory distress, Birth, Neonatal, Risk factor, Child, Human, Epidemiology, California, United States, North America, America, Nervous system diseases, Central nervous system disease, Cerebral disorder, Respiratory disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0226903
Code Inist : 002B17A03. Création : 16/11/1999.