Article

We sought to investigate how brain injury and severity, and neurological
subtype of cerebral palsy (CP) differed in term-born children with CP after
neonatal encephalopathy, between those with suspected birth asphyxia and those
without. METHOD: Using the Canadian CP Registry, which included 1001 children,
those with CP born at >/=36wks after moderate or severe neonatal encephalopathy,
were dichotomized according to the presence or absence of suspected birth
asphyxia. Gross Motor Function Classification System (GMFCS) scores, neurological
subtypes, comorbidities, and magnetic resonance imaging findings were compared.
RESULTS: Of the 147 term-born children with CP (82 males, 65 females; median age
37 months, interquartile range [IQR] 26-52.5) who after moderate or severe
neonatal encephalopathy had the required outcome data, 61 (41%) met criteria for
suspected birth asphyxia. They had a higher frequency of non-ambulatory GMFCS
status (odds ratio [OR] 3.4, 95% confidence interval [CI] 1.72-6.8), spastic
quadriplegia (OR 2.8, 95% CI 1.4-5.6), non-verbal communication skills impairment
(OR 4.2, 95% CI 2.0-8.6), isolated deep grey matter injury (OR 4.1, 95% CI
1.8-9.5), a lower frequency of spastic hemiplegia (OR 0.17, 95% CI 0.07-0.42),
focal injury (OR 0.20; 95% CI 0.04-0.93), and more comorbidities (p=0.017) than
those who did not meet criteria. INTERPRETATION:
Term-born children who develop
CP after neonatal encephalopathy with suspected birth asphyxia have a greater
burden of disability than those without suspected birth asphyxia.
CI - (c) 2015 Mac Keith Press.

Langue : ANGLAIS