BJOG : an international journal of obstetrics and gynaecology · 2016
Clinical profile of children with cerebral palsy born term compared with late- and post-term: a retrospective cohort study.
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Frank R, Garfinkle J, Oskoui M, Shevell M I
Аннотация
OBJECTIVE: To determine whether cerebral palsy (CP) risks factors, neurological subtype, severity and co-morbidities differ between early/full-term-born children with CP compared with those born late/post-term.
DESIGN: Retrospective cohort study.
SETTING: Children with CP born between 1998 and 2014, residing in Canada, and registered in the Canadian Cerebral Palsy Registry (CCPR) (n = 1691), a database with information from 15 participating centres across six Canadian provinces.
POPULATION: Children with CP from the CCPR born at 37 weeks of gestation and later (n = 802).
METHODS: The clinical profile of children with CP born at 37-40 weeks of gestation was compared with those born at 41 weeks and later using the Pearson chi-square test (or Fisher's exact test) for univariate analyses of categorical data. A P value <0.05 was considered significant a priori.
MAIN OUTCOME MEASURES: CP neurological subtype, Gross Motor Function Classification System (GMFCS) severity, risk factors and co-morbidities.
RESULTS: Neonatal encephalopathy was found in 23.9% of children with CP born early/full-term and in 33.6% of those born late/post-term (P = 0.026). Neonatal hyperbilirubinaemia was found in 10.2% of children born in the earlier period and in 2.6% of those born in the later period (P = 0.008). Apgar score at 5 minutes, but not 10 minutes, was significantly higher in the early/full-term group (9) compared with its late/post-term counterpart (7; P = 0.046). Rates of CP subtype, severity (GMFCS) and co-morbidities did not differ significantly between the two gestational periods.
CONCLUSIONS: In children with CP, neonatal encephalopathy was significantly less frequent and neonatal hyperbilirubinaemia was significantly more frequent in those born early/full-term compared with their later-born counterparts. However, clinical outcomes of CP were not significantly different between these two gestational epochs.
TWEETABLE ABSTRACT: Children with cerebral palsy born early/full-term have similar outcomes to those born late/post-term.
DESIGN: Retrospective cohort study.
SETTING: Children with CP born between 1998 and 2014, residing in Canada, and registered in the Canadian Cerebral Palsy Registry (CCPR) (n = 1691), a database with information from 15 participating centres across six Canadian provinces.
POPULATION: Children with CP from the CCPR born at 37 weeks of gestation and later (n = 802).
METHODS: The clinical profile of children with CP born at 37-40 weeks of gestation was compared with those born at 41 weeks and later using the Pearson chi-square test (or Fisher's exact test) for univariate analyses of categorical data. A P value <0.05 was considered significant a priori.
MAIN OUTCOME MEASURES: CP neurological subtype, Gross Motor Function Classification System (GMFCS) severity, risk factors and co-morbidities.
RESULTS: Neonatal encephalopathy was found in 23.9% of children with CP born early/full-term and in 33.6% of those born late/post-term (P = 0.026). Neonatal hyperbilirubinaemia was found in 10.2% of children born in the earlier period and in 2.6% of those born in the later period (P = 0.008). Apgar score at 5 minutes, but not 10 minutes, was significantly higher in the early/full-term group (9) compared with its late/post-term counterpart (7; P = 0.046). Rates of CP subtype, severity (GMFCS) and co-morbidities did not differ significantly between the two gestational periods.
CONCLUSIONS: In children with CP, neonatal encephalopathy was significantly less frequent and neonatal hyperbilirubinaemia was significantly more frequent in those born early/full-term compared with their later-born counterparts. However, clinical outcomes of CP were not significantly different between these two gestational epochs.
TWEETABLE ABSTRACT: Children with cerebral palsy born early/full-term have similar outcomes to those born late/post-term.