Article

We have identified an excess of children with cerebral palsy (CP) born to
women who received antibiotic treatment for spontaneous preterm labour (SPL).
This nested study investigated the profile of impairment among children with CP
in the ORACLE Children Study (OCS), and contrasted outcomes with those in 4Child,
a population CP registry. Method The study group comprised 167 children aged from
7 to 10 years (100 males, 67 females) with CP from the OCS, who were subdivided
into a preterm rupture of membranes (PROM) group (87 children) and an SPL group
(80 children). The OCS sought follow-up information regarding the health and
behaviour of surviving children at 7 years of age in the UK using a parent-report
postal questionnaire. Families provided further information to define wider
aspects of function and were offered a physiotherapy assessment. Results The
prevalence of CP was higher among children in the OCS than among those in 4Child
(standardized morbidity ratios : SPL group, 3.12 [95% confidence interval CI
2.47-3.87); PROM group: 1.56 (CI 1.24-1.92)]. The proportion of children with CP
born after 32 weeks of gestation was higher in in the SPL group (73%) than in the
PROM group (30%); the prevalence of CP was higher in the SPL group than in the
PROM group or 4Child. Children with CP in the OCS tended to have similar
distributions of neuroimpairment as children in 4Child, but motor impairment and
associated vision and hearing problems were found to be less severe.
Interpretation The pattern of CP in both the PROM and the SPL groups was similar,
but functional outcomes were milder, compared with children with CP in the
general population. However, in these groups the risk of CP was increased
independently of gestational age. This is consistent with findings that ongoing
inflammatory damage can cause CP. CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS