Risk Factors for Cerebral Palsy in Very Low-Birthweight Infants in the 1980s and 1990s

Abstract

One-hundred twenty-nine very low-birthweight infants were treated in Newborn and Infant Care Department of Children's Memorial Health Institute between 1985 and 1994; 89 were taken to prospective neurodevelopmental care. The newborns were divided into two groups. Group I had 38 preterm infants born from 1985 to 1989 and followed up at 7 to 11 years of age. Group II had 51 very low-birthweight infants treated from 1990 to 1994 and followed up at 2 to 5 years of age. Complicated, multiple pregnancy, normal delivery, and extremely low birthweight were significantly more frequent in group II. Very low-birthweight infants were frequently born by cesarean section in severe asphyxia. Only four (7.8%) newborns received surfactant therapy. From 1990 to 1994, respiratory distress syndrome III and IV, and a longer respiratotherapy period were significantly more frequent. From 1985 to 1994, the frequency of sepsis, periventricular leukomalacia, and normal ultrasonography was constant. Intraventricular hemorrhage I, II, and IV were frequently present in the 1990s, and intraventricular hemorrhage III was frequent in the 1980s. Cerebral palsy was diagnosed in 11 (28.9%) children in group I and 18 (35.2%) in group II (not statistically different). Multiple and complicated pregnancy, cesarean section, severe asphyxia, and respiratory distress syndrome did not increase the risk of cerebral palsy in very low-birthweight infants. Periventricular leukomalacia has a more predictive value for cerebral palsy in these infants than did intraventricular hemorrhage.

Maternal factors influencing low birth weight babies

“…2 In addition, LBW has a higher association with the incidence of infection, malnutrition and handicapping conditions during childhood. 3,4 In developing countries, many women are short and underweight and the number of low birth weight (LBW) babies is particularly high (more than 30% in South Asia, 10-20% in other regions. 5 LBW infants have less chance of survival; when they do survive, they are more prone to disease, growth retardation and impaired mental development.…”

Correlation of birth weight with other anthropometric variables in detection of low birth weight (LBW) babies

“…The current study was conducted to identify the suitable parameters to predict low birth weight babies and those who are at risks of adverse antenatal, perinatal and postnatal outcome. In Bangladesh, the prevalence of low birthweight is unacceptably high (varies between 23% and 60%) [6][7][8] , in the current study 38% of the babies were with low birth weight (1500-2500 gms) and 14% with every low birth weight (900-1500 gms). Considering that birth weight is not fully satisfying indices for prediction of perinatal risk and long term out come, an alternative or additive parameter has been searched for a long time.…”

“…In addition to its impact on infant mortality, LBW has been associated with higher probabilities of infection, malnutrition and handicapped conditions during childhood (including cerebral palsy), mental deficiencies and problems related to behavior and learning during childhood 5 . In Bangladesh, the prevalence of low birth-weight is unacceptably high (varies between 23% and 60%) which is more than twice the 15% threshold that indicates a public-health problem [6][7][8] . Low birth-weight (LBW) has serious implications for the growth, development, health, and survival of children and adults 9 .…”

Maternal Risk Factors Affecting Birth Weight of Newborn

“…3 In addition to its impact on infant mortality, LBW has been associated with higher possibilities of infection, malnutrition and handicapping condition during childhood including cerebral palsy, mental retardation and problems related to learning and behavior during childhood. 4,5 There is evidence that LBW or its determinant factors are associated with a predisposition to higher rate of diabetes mellitus, cardiac disease and other future chronic health problems. 6,7 The worldwide incidence of LBW is 17% per year making it an important health problem in many populations.…”