Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 4)
Cerebral palsy in preterm infants
Authors:
Čila Demeši Drljan, Aleksandra Mikov, Karmela Filipović, Snežana Tomašević Todorović, Aleksandar Knežević, Rastislava Krasnik
Background/Aim. Cerebral palsy (CP) is one of the leadingcauses of neurological impairment in childhood. Preterm birth
is a significant risk factor in the occurrence of CP. Clinical outcomes
may include impairment of gross motor function and
intellectual abilities, visual impairment and epilepsy. The aim of
this study was to examine the relationships among gestational
age, type of CP, functional ability and associated conditions.
Methods. The sample size was 206 children with CP. The data
were obtained from medical records and included gestational
age at birth, clinical characteristics of CP and associated conditions.
Clinical CP type was determined according to Surveillance
of Cerebral Palsy in Europe (SCPE) and topographically. Gross
motor function abilities were evaluated according to the Gross
Motor Function Classification System (GMFCS). Results.
More than half of the children with CP were born prematurely
(54.4%). Statistically significant difference was noted with respect
to the distribution of various clinical types of CP in relation
to gestational age (p < 0.001). In the group with spastic bilateral
CP type, there is a greater proportion of children born
preterm. Statistically significant difference was noted in the
functional classification based on GMFCS in terms of gestational
age (p = 0.049), children born at earlier gestational age
are classified at a higher GMFCS level of functional limitation.
The greatest percentage of children (70.0%) affected by two or
more associated conditions was found in the group that had
extremely preterm birth, and that number declined with increasing
maturity at birth. Epilepsy was more prevalent in children
born at greater gestational age, and this difference in distribution
was statistically significant (p = 0.032). Conclusion.
The application of antenatal and postnatal protection of preterm
children should be a significant component of the CP
prevention strategy.
