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Cerebral palsy following term newborn encephalopathy: a population-based study

Published online by Cambridge University Press:  14 April 2005

Nadia Badawi
Affiliation:
Department of Neonatology, The Children's Hospital at Westmead, University of Sydney, Sydney, Australia.
Janine F Felix
Affiliation:
Paediatric Surgical Intensive Care Unit, Sophia Children's Hospital, Rotterdam, the Netherlands.
Jennifer J Kurinczuk
Affiliation:
National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
Glenys Dixon
Affiliation:
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Australia.
Linda Watson
Affiliation:
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Australia.
John M Keogh
Affiliation:
Hornsby Ku-Ring Gai Hospital, University of Sydney, Sydney, Australia.
Jane Valentine
Affiliation:
Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Australia.
Fiona J Stanley
Affiliation:
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Australia.
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Abstract

Cerebral palsy (CP) can occur in term infants with or without preceding newborn encephalopathy. We compared the type and severity of CP and associated disability in these two groups. Participants from a population-based case-control study of term newborn encephalopathy were followed up for 6 years and linked to the Western Australian Cerebral Palsy Register. The remaining term infants with CP for the same period were also identified from the Cerebral Palsy Register. 13% of neonatal survivors of term newborn encephalopathy had CP, a rate of 116 per 1000 term live births. Overall, 24% of term infants with CP followed newborn encephalopathy. CP following newborn encephalopathy was more likely to: affect males (72% vs 56%); be severe (47% vs 25%); and be of spastic quadriplegia or dyskinetic types. Cognitive impairment was more common (75% vs 43%) and severe (41% vs 16%), as was epilepsy (53% vs 29%) in survivors of encephalopathy. These children were also more likely to: be non-verbal (47% vs 22%); have a severe composite disability score (47% vs 26%); and die between time of diagnosis of CP and age 6 years (5-year cumulative mortality 19% vs 5%). Children born at term who develop CP following newborn encephalopathy have a poorer prognosis than those with CP who were not encephalopathic in the first week of life.

Type
Original Articles
Copyright
© 2005 Mac Keith Press

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