Cerebral palsy trends Implications for perinatal care

1994 ◽  
Vol 73 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Fiona J. Stanley
Keyword(s):  
Cerebral Palsy ◽  
Perinatal Care

PREMATURITY AND CP: A COMMON CAUSE?

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. A72-A72
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Perinatal Asphyxia ◽  
Perinatal Care ◽  
Developed Countries ◽  
Low Birth Weight Infants ◽  
Common Cause ◽  
Improvement In Survival

. . .cerebral palsy rates in infants with birth weights under 1500 g increased from 12.1 to 64.9 [per 1000 births]. These results, which are similar to those found in other developed countries, suggest that improved perinatal care, including increased use of interventions to prevent perinatal asphyxia, has improved neonatal survival but not the rate of cerebral palsy. In low-birth-weight infants the rising cerebral palsy rate has paralleled the improvement in survival; one explanation for this finding is that low birth weight and cerebral palsy both result from an insult that occurs well before birth.

scholarly journals Weekend and off-hour effects on the incidence of cerebral palsy: contribution of consolidated perinatal care

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Satoshi Toyokawa ◽  
Junichi Hasegawa ◽  
Tsuyomu Ikenoue ◽  
Yuri Asano ◽  
Emi Jojima ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Cesarean Section ◽  
Medical Care ◽  
Perinatal Care ◽  
Night Shift ◽  
Significant Risk ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Emergent Cesarean Section ◽  
Spontaneous Delivery

Abstract Objective This study estimated the effects of weekend and off-hour childbirth and the size of perinatal medical care center on the incidence of cerebral palsy. Methods The cases were all children with severe cerebral palsy born in Japan from 2009 to 2012 whose data were stored at the Japan Obstetric Compensation System for Cerebral Palsy database, a nationally representative database. The inclusion criteria were the following: neonates born between January 2009 and December 2012 who had a birth weight of at least 2000 g and gestational age of at least 33 weeks and who had severe disability resulting from cerebral palsy independent of congenital causes or factors during the neonatal period or thereafter. Study participants were restricted to singletons and controls without report of death, scheduled cesarean section, or ambulance transportation. The controls were newborns, randomly selected by year and type of delivery (normal spontaneous delivery without cesarean section and emergency cesarean section) using a 1:10 case to control ratio sampled from the nationwide Japan Society of Obstetrics and Gynecology database. Results A total of 90 cerebral palsy cases and 900 controls having normal spontaneous delivery without cesarean section were selected, as were 92 cerebral palsy cases and 920 controls with emergent cesarean section. A significantly higher risk for cerebral palsy was found among cases that underwent emergent cesarean section on weekends (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.06–2.81) and during the night shift (OR 2.29, 95% CI 1.30–4.02). No significant risk was found among normal spontaneous deliveries on weekends (OR 1.63, 95% CI 0.97–2.73) or during the quasi-night shift (OR 1.26, 95% CI 0.70–2.27). Regional perinatal care centers showed significantly higher risk for cerebral palsy in both emergent cesarean section (OR 2.35, 95% CI 1.47–3.77) and normal spontaneous delivery (OR 2.92, 95% CI 1.76–4.84). Conclusion Labor on weekends, during the night shift, and at regional perinatal medical care centers was associated with significantly elevated risk for cerebral palsy in emergency cesarean section.

scholarly journals Cerebral Palsy: State of Art

2010 ◽  
Vol 4 (2) ◽  
pp. 189-198
Author(s):  
Ulrich Honemeyer ◽  
Amira Talic
Keyword(s):  
Cerebral Palsy ◽  
Genetic Factors ◽  
Perinatal Care ◽  
Effective Prevention ◽  
Motor Disability ◽  
Live Births ◽  
Functional Maturation ◽  
4D Ultrasound ◽  
Normal Functional ◽  
The Subject

Abstract Cerebral palsy (CP) is the most common motor disability in childhood. It affects 2 to 2.5 children in 1000 live-births, with 20 to 30 fold increased prevalence in preterm infants. Despite of progress in perinatal care, the prevalence of cerebral palsy did not change in the last 50 years. New knowledge about etiological factors, such as inflammation, elevated level of cytokines, vascular strokes and genetic factors shift the origin of cerebral palsy mostly into antenatal period, making intrapartal damage responsible for less than 10% of cases. CP is becoming increasingly the subject of interdisciplinary research. Fetal neurosonography with a growing number of studies promises better understanding of the normal functional maturation of the human brain which may lead to effective prevention and treatment of cerebral palsy. Advances in 4D ultrasound resulted in development of KANET as tool for detection of abnormal fetal behavior.

scholarly journals Aetiology and comorbidities of cerebral palsy in a developing country

2018 ◽  
Vol 6 (10) ◽  
pp. 3246 ◽  
Author(s):  
Komomo I. Eyong ◽  
Asindi A. Asindi ◽  
Chimaeze Torty
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Social Class ◽  
Perinatal Care ◽  
Birth Asphyxia ◽  
Cortical Atrophy ◽  
Dominant Type ◽  
Care Givers ◽  
Neurology Clinic ◽  
Pregnancy And Delivery

Background: Cerebral palsy (CP) is a common disabling condition of movement and posture causing activity limitation arising from a static injury to the developing brain. Common risk factors for cerebral palsy in Africa include severe birth asphyxia, kernicterus and neonatal infections. This study is aimed at determining the aetiology and comorbidities associated with cerebral palsy in our environment.Methods: All children with CP presenting to the Paediatric Neurology clinic of the University of Calabar Teaching Hospital whose parent gave consent were recruited into the study. The biodata of the children and that of the parent’s/ care givers were obtained. A detailed pregnancy and delivery history, neonatal history, seizures during first three years of life and developmental mile stones was documented.Results: Seventy children with CP were recruited into the study of which 46 (65.7%) were males and 24 (34.3%) females. Majority of the children were from low social class and products of home, church or TBA’S delivery where supervision is poor. Severe birth asphyxia and CNS infections are the commonest identified risk factors. Spastic quadriplegic CP is the dominant type of CP followed by spastic hemiplegia. There is a significant statistical relationship between the aetiology and the type of CP. Epilepsy (60%) speech defect (42.9%) and microcephaly (40%) are the predominant comorbidities seen in the study. Cortical atrophy and ventricular dilatation are predominant CT findings in contrast to periventricular leukomalecia seen in developed countries.Conclusions: Majority of the patients with CP in this study are from low social class and were delivered in places with poor obstetrics care. Improved perinatal care through an adequate social support system may reduce the burden of the disease.

scholarly journals Causes, functional outcomes and healthcare utilisation of people with cerebral palsy in Singapore

2021 ◽  
Vol 50 (2) ◽  
pp. 111-118 ◽  
Author(s):  
Zhi Min Ng ◽  
Jeremy B Lin ◽  
Poh Choo Khoo ◽  
Victor Samuel Rajadurai ◽  
Derrick WS Chan ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Functional Outcomes ◽  
Perinatal Care ◽  
Clinical Information ◽  
Healthcare Utilisation ◽  
Perinatal Period ◽  
University Hospital ◽  
Service Utilisation ◽  
Patient Reported ◽  
National University

Introduction: A voluntary cerebral palsy (CP) registry was established in 2017 to describe the clinical characteristics and functional outcomes of CP in Singapore. Methods: People with CP born after 1994 were recruited through KK Women’s and Children’s Hospital, National University Hospital and Cerebral Palsy Alliance Singapore. Patient-reported basic demographics, service utilisation and quality of life measures were collected with standardised questionnaires. Clinical information was obtained through hospital medical records. Results: Between 1 September 2017 and 31 March 2020, 151 participants were recruited. A majority (n=135, 89%) acquired CP in the pre/perinatal period, where prematurity (n=102, 76%) and the need for emergency caesarean section (n=68, 50%) were leading risk factors. Sixteen (11%) of the total participants had post-neonatally acquired CP. For predominant CP motor types, 109 (72%) had a spastic motor type; 32% with spastic mono/hemiplegia, 41% diplegia, 6% triplegia and 21% quadriplegia. The remaining (42, 27.8%) had dyskinetic CP. Sixty-eight (45.0%) participants suffered significant functional impairment (Gross Motor Functional Classification System levels IV–V). Most participants (n=102, 67.5%) required frequent medical follow-up (≥4 times a year). Conclusion: Optimisation of pre- and perinatal care to prevent and manage prematurity could reduce the burden of CP and their overall healthcare utilisation. Keywords: Cerebral palsy, functional outcomes, neonatal, registry

scholarly journals An Attempt to Discover Antenatal Etiological Factors for Cerebral Palsy: What does 3D and 4D Ultrasonography Add?

2007 ◽  
Vol 1 (4) ◽  
pp. 29-39
Author(s):  
Guillermo Azumendi ◽  
Ingrid Marton ◽  
Asim Kurjak ◽  
Mislav Herman
Keyword(s):  
Cerebral Palsy ◽  
Consensus Statement ◽  
Task Force ◽  
Perinatal Care ◽  
Assessment Method ◽  
4D Ultrasound ◽  
Mature Brain ◽  
Methods Of Evaluation ◽  
Infant Brain ◽  
And Behavior

Abstract Cerebral palsy (CP) is a nonprogressive condition affecting developing fetal or infant brain resulting in disorders of movement and posture which are sometimes accompanied by disturbances of cognition, sensation, perception, behavior and seizures. The incidence of CP being 2 to 2.5 per 1000 live births did not considerably change in the last decades. Improvement of perinatal care did not result in the decreasing prevalence of CP. Consensus Statement of International Cerebral Palsy Task Force and its modification presented the essential criteria to define an acute intrapartum event sufficient to cause CP. These criteria were not helpful in allocating the time of brain injury, proving that etiology of CP is difficult to investigate. Better markers of acute intrapartum injury should be defined, although much evidence exists that most causes of CP are prenatal. Advances in 3D and 4D ultrasound (US) give opportunities to investigate fetal morphology and behavior. By 4D US, head, body and limb movements can be visualized simultaneously. The earliest phase of development can be studied in detail, making 4D superior compared to 2D. Is applicable neurological test for fetus available? This question is complicated, because even postnatally several neurological methods of evaluation exist, while hardly accessible fetus has less mature brain. Inexistence of reliable neurobehavioral assessment method for the fetuses is discouraging. The scientific community should intensify efforts in finding out simple, clinically applicable, and reproducible fetal neurological test(s), with fair sensitivity and specificity.

Remaining Sequelae With Modern Perinatal Care

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 652-658
Author(s):  
K.-G. Sabel ◽  
R. Olegård ◽  
L. Victorin
Keyword(s):  
Cerebral Palsy ◽  
Viral Infections ◽  
Perinatal Care ◽  
Psychomotor Retardation ◽  
Total Incidence ◽  
Hearing Defect ◽  
Intrauterine Diagnosis ◽  
Perinatal Treatment ◽  
Malformation Syndromes ◽  
Intrauterine Malnutrition

The incidence of major sequelae—cerebral palsy (CP), psychomotor retardation (PMR), sensorineural hearing defect, and acquired hydrocephalus—has been studied retrospectively in a nonselected population of 6,500 3-year-old children born in 1969 and 1970 at one Swedish hospital and treated uniformly according to the principles of modern perinatology. The total incidence of these four types of handicaps was 3.5 per 1,000 when children with congenital malformation syndromes, chromosomal aberrations, verified congenital viral infections, or toxoplasmosis were excluded. The incidence of CP was 1.2 per 1,000. Extreme immaturity, traumatic delivery, postnatal asphyxia, and hyperbilirubinemia were found to be relatively small factors as causes of sequelae in this population. Babies showing various degrees of intrauterine malnutrition were found to be the major remaining group at risk for PMR and/or CP, two thirds of children with these handicaps being recruited from the 16% of newborns with birthweights more than 1 SD below normal in relation to gestational age. The most important further gains can probably be made by earlier intrauterine diagnosis of these cases, induced termination of pregnancy in selected cases, and further studies on the perinatal treatment and adaptation of these infants.

scholarly journals Perinatal care with a view to preventing cerebral palsy

2020 ◽  
Vol 63 (2) ◽  
pp. 156-161
Author(s):  
Nadia Badawi ◽  
Sarah Mcintyre ◽  
Rod W Hunt
Keyword(s):  
Cerebral Palsy ◽  
Perinatal Care
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