Case gender and severity in cerebral palsy varies with intrauterine growth

Abstract

Background: There is an unexplained excess of cerebral palsy among male babies. There is also variation in the proportion of more severe cases by birth weight. It has recently been shown that the rate of cerebral palsy increases as intrauterine size deviates up or down from an optimum about one standard deviation heavier than population mean weight-for-gestation. Aims: To determine whether the gender ratio or the severity of cases also varies with intrauterine size. Methods: A total of 3454 cases of cerebral palsy among single births between 1976 and 1990 with sufficient data to assign case severity (based on intellectual impairment and walking ability) and to compare weight-for-gestation at birth to sex specific fetal growth standards, were aggregated from nine separate registers in five European countries. Results: The greater the degree to which growth deviates either up or down from optimal weight-forgestation at birth, the higher is the rate of cerebral palsy, the larger is the proportion of male cases, and the more severe is the functional disability. Compared to those with optimum growth the risk of more severe cerebral palsy in male babies is 16 times higher for those with a birth weight below the 3rd centile and four times higher when birth weight is above the 97th centile. In contrast, for mild cerebral palsy in female babies the excess risks at these growth extremes are about half these magnitudes. Conclusions: Among singleton children with cerebral palsy, abnormal intrauterine size, either small or large, is associated with more severe disability and male sex.

The association of genetic polymorphisms with cerebral palsy: a meta-analysis

“…Additionally, there is an unexplained excess of CP among male infants. 36 The sexassociated difference in susceptibility indicates that the cause of CP may be different in males and females. Thus, subgroup analysis by sex may be helpful to identify the cause of CP.…”

Diffusion Tensor Imaging Abnormalities in the Cerebral White Matter Correlate with Sex-Dependent Neurobehavioral Deficits in Adult Mice with Neonatal Ischemia

“…Little is known about the underlying mechanisms leading to such sex differences; however, animal studies have shown that the endogenous reaction to developmental injury is highly dependent on sex [20]. In a large European study involving 4,500 infants with cerebral palsy, incidence rates were 30% higher in males than females [21]; the EPICure Study reported similar differences, including lower cognitive scores at the age of 6 years in males [22]. A recent meta-analysis reported higher full-scale IQ scores in females born prematurely compared to matched males [23].…”

The Result of Functional Mobility Scale (FMS) on Cerebral Palsy Spastic Diplegic that treated by SEMLS (Single Event Multi Level Surgey) method in Orthopaedic Hospital Prof. Dr. R. Soeharso, Surakarta

“…Increased incidence of CP supposedly correlates with increased survival rates of premature or low birth weight children Cerebral Palsy most commonly experienced by male infants. In a study conducted by Johnstoneand Hagberg (2007); Jarvis et al, (2005) CP cases is more commonly observed in male gender as much as 30% when compared with female gender.…”