Spastic diplegia in premature infants. Etiologic and diagnostic considerations.

To investigate the etiology of spastic diplegia (SD) of prematurity, we compared the prenatal, perinatal, and neonatal course of 18 preterm infants with SD to that of a control group of preterm infants without SD. No significant differences between the group with SD and the control group were found in most of the perinatal and neonatal factors analyzed. Significant differences were found in birth weight, birth head circumference, and the one-minute Apgar score. Controlling for gestational age, infants with SD weighed less at birth, had smaller heads, and were more often briefly neurologically depressed. Intracranial hemorrhage and neonatal seizures occurred significantly more often in infants with SD. Fifteen infants with SD were believed to be neurologically normal at the time of nursery discharge. These findings suggest the importance of prenatal factors in optimally treated preterm infants in whom SD develops.