Article Text

PERINATAL AND NEONATAL COMPLICATIONS ASSOCIATED WITH CEREBRAL PALSY IN EXTREMELY LOW BIRTH WEIGHT INFANTS
  1. Z Stranak1,
  2. Z Hodkova1,
  3. J Semberova1,
  4. J Miletin1
  1. 1Institute for The Care of Mother and Child, Prague, Czech Republic

Abstract

Objectives The aim of the study was to assess the association of cerebral palsy in extremely low birth weight (ELBW; birth weight <1000 g) at 2 years of age and serious perinatal and neonatal complications.

Design Prospective cohort study in tertiary perinatal centre.

Methods 275 ELBW patients were analyzed and followed up in 2 years of corrected age. Select maternal and infant variables were abstracted from the medical records. Neonatal morbidities, Mental Developmental Index (MDI) score, Psychomotor Developmental Index (PDI) score, the presence of visual and hearing impairment and cerebral palsy were assessed.

Results Survival rate was 65% at 2 corrected age (180 patients). Follow up was collected in 154 infants (86%). Comparison of patients with cerebral palsy (CP group) and normal neurodevelopment (NCP group) has found statistically significant differences in: birth weight, gestational age, CRIB, duration of artificial ventilation, duration of total parenteral nutrition and hospital stay. Univariate associations with cerebral palsy disclosed impact of sepsis, periventricular leukomalacia, bronchopulmonary dysplasia, periventricular-intraventricular haemorrhage ⩾III.grade, patent ductus arteriosus and retinopathy of prematurity. Caesarean section and growth restriction were associated with lower incidence of cerebral palsy. Logistic regression confirmed negative role of periventricular leukomalacia, bronchopulmonary dysplasia and periventricular-intraventricular haemorrhage ⩾III.grade in the development of cerebral palsy.

Conclusions The cerebral palsy is strongly associated not only with severe life threatening neurologic complications but also with less hazardous non-neurological diseases.

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