Document Detail


Predictability of cerebral palsy in a high-risk NICU population.
MedLine Citation:
PMID:  20542648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: This study aims to create a predictive model for the assessment of the individual risk of developing cerebral palsy in a large cohort of selected high-risk infants.
PATIENTS AND METHODS: 1099 NICU-admitted high-risk infants were assessed up to the corrected age of at least 12 months. CP was categorized relative to subtype, distribution and severity. Several perinatal characteristics (gender, gestational age, multiple gestation, small for gestational age, perinatal asphyxia and duration of mechanical ventilation), besides neonatal cerebral ultrasound data were used in the logistic regression model for the risk of CP.
RESULTS: Perinatal asphyxia, mechanical ventilation>7 days, white matter disease except for transient echodensities<7 days, intraventricular haemorrhage grades III and IV, cerebral infarction and deep grey matter lesions were recognized as independent predictors for the development of CP. 95% of all children with CP were correctly identified at or above the cut-off value of 4.5% probability of CP development. Higher gestational age, perinatal asphyxia and deep grey matter lesion are independent predictors for non-spastic versus spastic CP (OR=1.1, 3.6, and 7.5, respectively). Independent risk factors for prediction of unilateral versus bilateral spastic CP are higher gestational age, cerebral infarction and parenchymal haemorrhagic infarction (OR=1.2, 31, and 17.6, respectively). Perinatal asphyxia is the only significant variable retained for the prediction of severe CP versus mild or moderate CP.
CONCLUSION: The presented model based on perinatal characteristics and neonatal US-detected brain injuries is a useful tool in identifying specific infants at risk for developing CP.
Authors:
E Himpens; A Oostra; I Franki; S Vansteelandt; P Vanhaesebrouck; C Van den Broeck
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Publication Detail:
Type:  Journal Article     Date:  2010-06-09
Journal Detail:
Title:  Early human development     Volume:  86     ISSN:  1872-6232     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-08-03     Completed Date:  2010-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  413-7     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Ltd. All rights reserved.
Affiliation:
Ghent University, Belgium. eveline.himpens@ugent.be
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MeSH Terms
Descriptor/Qualifier:
Cerebral Palsy / diagnosis*,  ultrasonography
Cohort Studies
Echoencephalography
Female
Gestational Age
Humans
Infant
Infant, Newborn
Intensive Care Units, Neonatal
Logistic Models*
Male
Pregnancy
Pregnancy, Multiple
Regression Analysis
Respiration, Artificial / adverse effects
Risk Assessment
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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