Severity of Cerebral Palsy—The Impact of Associated Impairments

2020 ◽  
Vol 51 (02) ◽  
pp. 120-128 ◽  
Author(s):  
Veronka Horber ◽  
Asma Fares ◽  
Mary Jane Platt ◽  
Catherine Arnaud ◽  
Ingeborg Krägeloh-Mann ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Age Groups ◽  
Walking Ability ◽  
Age Group ◽  
Intellectual Impairment ◽  
Weight Group ◽  
Birth Weight Group ◽  
The Impact

Abstract Objective This article describes associated impairments in children with cerebral palsy (CP) and its subtypes. Method Children born between 1990 and 2006 recorded in the Surveillance of Cerebral Palsy in Europe common database were studied. An “impairment index” characterized severity of impairments and their combinations. Results Amongst the 11,015 children analyzed, 56% (n = 5,968) could walk unaided, 54% (4,972) had normal or near-normal intellect (intelligence quotient ≥ 70). Except for ataxic CP, associated impairments were less frequent when walking ability was preserved. The impairment index was low (walking unaided and normal or near-normal intellect) in 30% of cases; 54% (n = 1,637) in unilateral spastic, 24% (n = 79) in ataxic, 18% (n = 913) in bilateral spastic, and 7% (n = 50) in dyskinetic CP. Around 40% had a high impairment index (inability to walk and/or severe intellectual impairment ± additional impairments)—highest in dyskinetic (77%, n = 549) and bilateral spastic CP (54%, n = 2,680). The impairment index varied little in birth weight and gestational age groups. However, significantly fewer cases in the birth weight group ≤ 1,000 g or gestational age group ≤ 27 weeks had a low impairment index compared to the other birth weight and gestational age groups (23 and 24% vs. between 27 and 32%). Conclusion Thirty percent of the children with CP had a low impairment index (they were able to walk unaided and had a normal or near-normal intellect). Severity in CP was strongly associated to subtype, whereas the association was weak with birth weight or gestational age.

European and Australian Cerebral Palsy Surveillance Networks Working Together for Collaborative Research

2020 ◽  
Vol 51 (02) ◽  
pp. 105-112 ◽  
Author(s):  
Elodie Sellier ◽  
Sarah McIntyre ◽  
Hayley Smithers-Sheedy ◽  
Mary Jane Platt ◽  
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Collaborative Research ◽  
Health Care Systems ◽  
Age Groups ◽  
Subtle Difference ◽  
Care Systems ◽  
Working Together ◽  
Working Practices

Abstract Aims This study aims to describe and compare goals and methods, characteristics of children with cerebral palsy (CP), and to compare prevalence of CP in the Surveillance of Cerebral Palsy in Europe (SCPE) and the Australian Cerebral Palsy Register (ACPR). Methods This study compares the objectives of the two networks and their working practices; key documents from both above-mentioned networks were used. Children included in the comparison of the descriptive profile and prevalence measures were born between 1993 and 2009 for Australian data and between 1980 and 2003 for SCPE. Results SCPE contributed 10,756 cases and ACPR 6,803. There were similar distributions of motor type, severity, and gestational age groups, except for the proportion of the lowest gestational age category (range, 20–27 weeks) which was twice higher in the ACPR (13 vs. 7%). Associated impairment proportions were also similar except for severe vision impairment which was more than twice as high in SCPE as in the ACPR (11 vs. 4%), but most likely due to a subtle difference in definitions. Prevalence rates were comparable at the same time point in the different groups of birth weight, and declined over time, except for the moderately low birth weight in ACPR. Conclusion Two CP networks representing two continents have compared their major characteristics to facilitate the comparison across their study populations. These characteristics proved to be similar with only marginal differences. This gives additional strength to the observation in both networks that CP prevalence is decreasing which is of great importance for families and health care systems.

scholarly journals The Association between Birth Weight and Gestational Age and Asthma in 6-7- and 13-14-Year-Old Children

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Zamani Raheleh ◽  
Alikhani Ahmad ◽  
Heydarzadeh Abtin ◽  
Zare Roghaye ◽  
Hashemain Sara ◽  
...  
Keyword(s):  
Birth Weight ◽  
Severe Asthma ◽  
Gestational Age ◽  
Lower Risk ◽  
Age Groups ◽  
Age Group ◽  
Group 13 ◽  
Increased Risk ◽  
Group 6

Background. Previous studies that assessed the role of birth weight and gestational age in the risk of asthma have been conflicting.Objectives. To examine the association between birth weight and gestational age and symptoms of asthma.Patients and Methods. Subjects were 6656 school children of ages 6-7 and 13-14 years from urban districts of Mazandaran, Iran. ISAAC questionnaires were used.Results. There was an increased risk of “wheeze ever” in both age groups with birth weight under 2.5 kg and in all subgroups of low birth weight (LBW). Birth weight more than 3.5 kg was associated with lower risk of “severe asthma” in age group 6-7 years. With respect to gestational age, higher risks of “wheeze ever,” “asthma ever,” and “night cough in the past 12 months” were found in age group 13-14 years born before 37 weeks and the risk of “severe asthma” was higher in younger group (6-7 years). A lower risk of "asthma ever" was also found in 6-7-year-old children and 13-14-year-old girls who were born after 40 weeks.Conclusions. This study showed that there is a direct relation between “wheeze ever” and LBW and an inverse relation between risk of “severe asthma” and birth weight more than 3.5 kg.

scholarly journals Desenvolvimento motor no primeiro ano de vida de crianças prematuras conforme o peso de nascimento

2017 ◽  
Vol 27 (3) ◽  
pp. 27079
Author(s):  
Raquel Saccani ◽  
Amanda Gomes Martins ◽  
Priscila De Oliveira Pinto
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Motor Development ◽  
Strong Association ◽  
First Year ◽  
Weight Group ◽  
Chi Square ◽  
Birth Weight Group ◽  
First Year Of Life

***Motor development in the first year of life of premature infants according to birth weight***AIMS: To assess motor development in the first year of life of children born at 36 weeks' gestational age, comparing two groups, one with birth weight below 2500g and the other with 2500g or more.METHODS: A cross-sectional study evaluated the motor development of children enrolled in the Basic Health Units of Caxias do Sul and Porto Alegre, by the Alberta Infant Motor Scale. The sample consisted of infants born at 36 weeks' gestation, evaluated with a corrected chronological age of 0 to 12 months, divided into two groups: Low Birth Weight group (LBW group: birth weight below 2,500 g) and Adequate Birth Weight group (ABW group: birth weight of 2,500 g or more). The independent t-test, the chi-square test of Pearson and the Eta2 test (strong association> 0.60) were used to analyze the data. P <0.05 was considered significant.RESULTS: We evaluated 42 children, 21 in each group. Fifteen (71.42%) children with low birth weight were classified as small for gestational age. The mean motor development score percentile was 17.90±17.74 for the LBW group and 34.57±25.80 for the ABW group, indicating a better motor development of the second group (p=0.02) . There was a greater number of children with developmental delay in the LBW group (52.4%), whereas in the ABW group most were within the normal range (47.6%). The association was statistically significant between performance categories and birth weight groups, using the chi-square test (p=0.001), with Eta2=0.64 (strong association).CONCLUSIONS: In preterm infants with matched gestational age at 36 weeks, the low birth weight group had worse motor performance in the first year of life compared to the group with adequate birth weight.

scholarly journals Serum carnitine, triglyceride and cholesterol profiles in Korean neonates

2007 ◽  
Vol 98 (2) ◽  
pp. 373-379 ◽  
Author(s):  
Eun-Mi Ahn ◽  
Soo-Chul Cho ◽  
Myoungsook Lee ◽  
Youn-Soo Cha
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Ldl Cholesterol ◽  
Age Groups ◽  
The Other ◽  
Age Group ◽  
Normal Birth ◽  
Lipid Status ◽  
Total Carnitine ◽  
Preterm Newborns

This study evaluated carnitine and lipid status of fifty Korean newborns. Each subject was assigned to two groups: one according to body weight at birth and the other according to gestational age. Serum total, HDL- and LDL-cholesterol were significantly lower and triacylglycerols were significantly higher, by 14 %, in the low birth weight infant (LBWI, 1310–2490 g) group compared with the normal birth weight infant (NBWI, 2570–4420 g) group. Neither birth weight nor gestational age affected serum total carnitine concentrations. However, serum ASAC (acid-soluble acylcarnitine) concentrations were 43 % higher (P < 0·001) in the LBWI group compared with the NBWI group, and approximately twice as high (P < 0·05) in the 28–32 gestational age group compared with the other gestational age groups. NEC (non-esterified acyl carnitine) fractions were significantly higher in the NBWI and 28–32 week groups (P < 0·001 andP < 0·05); consequently serum acyl/NEC carnitine ratios were four times higher in the LBWI group compared with the NBWI group and 2–3 times higher in the 25–32 week age group compared with the more advanced gestational age groups. Urinary carnitine excretion, including the NEC fraction and total carnitine, was significantly higher (P < 0·001) for LBWI than for NBWI. By gestational age, NEC excretion of the 28–32 week group was significantly (P < 0·05) higher than that of the other two groups, but total carnitine excretion was not different among the groups. This study demonstrated that Korean immature and preterm newborns have higher serum triacylglycerol concentrations but lower carnitine status than NBWI. Therefore, the lower carnitine status and moderately higher triacylglycerols may suggest that LBWI in Korea might be at risk for poor carnitine status and decreased capacity to utilise fatty acids for energy.

scholarly journals Characteristics and outcomes of low birth weight infants in Bali

2012 ◽  
Vol 52 (5) ◽  
pp. 300
Author(s):  
Putu Junara Putra
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Low Birthweight ◽  
Low Birth Weight Infants ◽  
Weight Group ◽  
Birth Weight Group ◽  
Appropriate For Gestational Age ◽  
Time Of Admission

Background The prevalence and the mortality of low birthweight infants are still high. Low birth weight (LBW) births areresponsible for newborn death. LBW infants are easier to sufferserious health problems and death. Lower infant body weightand younger gestational age are determinants of greater risk ofmortality.Objective To determine the characteristics of LBW infants andtheir outcomes in Sanglah Hospital, Denpasar.Methods This prospective study was conducted on all LBWinfants in the nursery from their time of admission until dischargefor the year of 20 11..Results There were 120 LBW infants admitted to SanglahHospital fromJanuary 2011 to December 2011. The prevalenceofLBW was 8.9%. The birth weight group of 1500􀁰2499 gramshad the highest number of infants (79.2%). The gestational agegroup of 33􀁰36 weeks had 53.3% of the infants, while 68.3% ofthe LBW infants were of the appropriate gestational age. Themost common method of delivery was normal spontaneousdelivery (70%). Moderate asphyxia was observed in 25% of thesubjects, while severe asphyxia was observed in 22.5% of subjects.The mortality rate was 24.2%.Conclusions The prevalence of LBW of all newborns in ourhospital was 8.9%. Severe asphyxia was observed in 22.5% ofsubjects. The mortality rate of the LBW infants was 24.2%. OurLBW infants were most cormnonly in the categories of birth weightof 1500􀁰2499 grams, gestational age was between 33􀁰36 weeks,appropriate for gestational age, as well as delivered spontaneously.[Paediatr lndanes. 2012,52:30003].

scholarly journals Risk factors for hip dislocation in dyskinetic cerebral palsy

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110011
Author(s):  
Kyoko Okuno ◽  
Yukihiro Kitai ◽  
Toru Shibata ◽  
Hiroshi Arai
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Lesion Location ◽  
Hip Displacement ◽  
Gmfcs Level

Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP). Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions. Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions. Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.

scholarly journals The effects of intrauterine undernutrition on pancreas ghrelin and insulin expression in neonate rats

2007 ◽  
Vol 194 (1) ◽  
pp. 121-129 ◽  
Author(s):  
Xiumin Wang ◽  
Li Liang ◽  
Lizhong Du
Keyword(s):  
Birth Weight ◽  
Plasma Insulin ◽  
Serum Insulin ◽  
Cell Distribution ◽  
Weight Group ◽  
Pregnant Rats ◽  
Normal Birth ◽  
Birth Weight Group ◽  
Total Ghrelin ◽  
Intrauterine Malnutrition

Ghrelin has a correlation with insulin secretion, β-cell development, and diabetes in crucial development period. The aim of this study was to compare the changes in plasma ghrelin, insulin, and glucose concentrations, and variation of ghrelin expression in the pancreas in response to intrauterine malnutrition in newborn rats. Pregnant rats at day 2 were randomly divided into two groups: nourished (fed ad libitum; NR) and undernourished rats (UR). The offspring of NR were defined as normal-birth-weight group (NBW, n = 79) and those of UR were defined as low-birth-weight group (LBW, n = 74). Plasma glucose, ghrelin, and serum insulin of both dams and their pups were analyzed at the first day after birth. The entire pancreas was collected for determination of ghrelin and insulin mRNAs, and quantification of pancreas ghrelin and insulin. Immunohistochemical double staining and confocal microscopy were performed on rat pancreas. Birth weight was 5.81 ± 0.64 and 4.76 ± 0.23 g in NBW group and LBW group respectively. Fasting plasma ghrelin concentrations in UR group (1382 (1287–1513) pg/ml) were higher than that of NR group (1072 (974–1205) pg/ml). Plasma ghrelin concentrations in the LBW group (2176 (2031–2384) pg/ml) were significantly lower than that of the NBW group (2493 (2311–2675) pg/ml). Undernutrition caused a decrease in plasma insulin concentrations in both UR dams and LBW pups (P < 0.001). Ghrelin mRNA and total ghrelin of pancreas were significantly affected by intrauterine nutrition state. Pancreas insulin concentrations were significantly affected by intrauterine nutrition (P = 0.007). The majority of ghrelin-producing cells were present at the periphery of islets in the NBW group. Ghrelin was colocalized with insulin in ß-cells in LBW group. The percentage of ghrelin-positive cells in the islets of LBW group was significantly higher than that of the NBW group (P < 0.01). Intrauterine undernutrition may affect the birth weight, plasma insulin and ghrelin levels, islet ghrelin expression, and ghrelin cell distribution. It will be interesting to investigate intrauterine nutrition which is involved in islet ghrelin expression and ghrelin cell distribution.

scholarly journals Clinical profile of newborns undergoing physical therapy in a neonatal intensive care unit

2016 ◽  
Vol 29 (3) ◽  
pp. 553-560 ◽  
Author(s):  
Graziela Ferreira Biazus ◽  
Cidia Cristina Kupke
Keyword(s):  
Birth Weight ◽  
Physical Therapy ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Extremely Low Birth Weight ◽  
Invasive Ventilation ◽  
Weight Group ◽  
Non Invasive ◽  
Birth Weight Group ◽  
Non Invasive Ventilation

Abstract Introduction: In neonatal therapy units, physical therapy is directed toward integral baby care. Objective: To describe the profile of newborns (NBs) hospitalized in a Neonatal Intensive Care Unit (NICU). Methods: Retrospective documentary study with data collection from medical records from July 2011 to July 2013. The sample consisted of NBs who performed motor and respiratory therapy. Data were grouped into five categories according to birth weight (≤ 1000g, 1001-1500g, 1501-2000g, 2001-2500g, ≥ 2501g). Results: total of 1,884 newborns were admitted to the NICU within the stipulated period, 168 (13.9%) underwent physical therapy. Of the 168 NBs who underwent physical therapy, 137 were born in the hospital (81.5%) and 31 were transferred there (18.5%); 17 of these babies died during the neonatal hospital stay (10.1%). All newborns of the extremely low birth weight group (≤ 1000g) required mechanical ventilation, 72.7% non-invasive ventilation and 16.6% high-frequency oscillatory ventilation. The occurrence of pneumothorax in the extremely low birth weight group was 13.8% and 16% in the group with birth weight 1001-1500g. Conclusion: Infants with low birth weight (<2500g) constituted the profile of NBs who underwent physical therapy, which was directly related to higher incidence of death and pneumothorax, as well as increased use of mechanical and non-invasive ventilation.

scholarly journals Birth-weight centiles and the risk of serious adverse neonatal outcomes at term

2018 ◽  
Vol 46 (9) ◽  
pp. 1048-1056 ◽  
Author(s):  
Joanna Yu ◽  
Christopher Flatley ◽  
Ristan M. Greer ◽  
Sailesh Kumar
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Neonatal Outcomes ◽  
Predicted Probability ◽  
Exposure Variable ◽  
Adverse Neonatal Outcomes ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Age At Birth

Abstract Background: Birth-weight is an important determinant of perinatal outcome with low birth-weight being a particular risk factor for adverse consequences. Aim: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies. Materials and methods: This was a retrospective cohort study of singleton term births at the Mater Mother’s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤−12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile. Results: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06–4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30–1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60–7.75). Conclusions: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.

scholarly journals Impact of parity and gestational age of mothers with hypertension on birth weight, red blood cells and mode of delivery of their babies

1970 ◽  
Vol 19 (4) ◽  
pp. 3038-3044
Author(s):  
Helen Chioma Okoye ◽  
Chilota Chibuife Efobi ◽  
Josephat Maduabuchi Chinawa ◽  
Odutola Israel Odetunde ◽  
Awoere Tamunosiki Chinawa ◽  
...  
Keyword(s):  
Birth Weight ◽  
Red Blood Cells ◽  
Cell Volume ◽  
Gestational Age ◽  
Packed Cell Volume ◽  
Blood Cells ◽  
Mode Of Delivery ◽  
Poor Correlation ◽  
Hypertensive Group ◽  
The Impact

Background: Maternal factors are determinants of birth outcome which includes birth weight, haematological indices and mode of delivery of their babies.Objectives: To determine the impact of parity and gestational age of hypertensive mothers on some neonatal variables.Methods: A hospital based cross-sectional study of measurement of neonatal variables (birth weight, red blood cells and mode of delivery) among hypertensive mothers and their controls was conducted over a period of six months. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20.Results: There were statistically significant differences in means between the neonates of the hypertensive group and non-hypertensive group for maternal age (t =1.61, p = 0.002), baby weight (t =2.87, p < 0.001), haemoglobin (Hb) (t =4.65, p = 0.010) and packed cell volume (PCV) (t =4.75, p = 0.009), but none for gravidity (t =1.95, p = 0.927)For all subjects, there was poor correlation between gestational age and variables; birth weight , haemoglobin (Hb), packed cell volume (PCV), nucleated red blood cell (nRBC) and parity. Likewise, parity poorly correlated with variables; age, birth weight, Hb, PCV, and nRBC. There was a statistically significant association between mode of delivery and hypertension (χ2 =53.082, p <0.001) but none with having a family history of hypertension (χ2 =1.13, p = 0.287).Conclusion: Parity and gestational age of mothers with hypertension have no impact on birth weight and red cells when compared with their non-hypertensive counterparts. However, mothers of babies delivered by elective and emergency caesarean section were about 2-3 times more likely to be hypertensive than those that delivered through spontaneous vertex delivery.Keywords: Hypertension; neonate; gestational age; parity.

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