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Children born at 32 to 35 weeks with birth asphyxia and later cerebral palsy are different from those born after 35 weeks

Journal of Perinatology volume 37, pages 963–968 (2017)Cite this article

Subjects

Abstract

Objective:

The objectives of this study were to (1) establish the proportion of cerebral palsy (CP) that occurs with a history suggestive of birth asphyxia in children born at 32 to 35 weeks and (2) evaluate their characteristics in comparison with children with CP born at ⩾36 weeks with such a history.

Study Design:

Using the Canadian CP Registry, children born at 32 to 35 weeks of gestation with CP with a history suggestive of birth asphyxia were compared with corresponding ⩾36 weeks of gestation children.

Results:

Of the 163 children with CP born at 32 to 35 weeks and 738 born at ⩾36 weeks, 26 (16%) and 105 (14%) had a history suggestive of birth asphyxia, respectively. The children born at 32 to 35 weeks had more frequent abruptio placenta (35% vs 12%; odds ratio (OR) 4.1, 95% confidence interval (CI) 1.5 to 11.2), less frequent neonatal seizures (35% vs 72%; OR 0.20, 95% CI 0.08 to 0.52), more frequent white matter injury (47% vs 17%; OR 4.3, 95% CI 1.3 to 14.0), more frequent intraventricular hemorrhage (IVH) (40% vs 6%; OR 11.2, 95% CI 3.4 to 37.4) and more frequent spastic diplegia (24% vs 8%; OR 1.8, 95% CI 1.2 to 12.2) than the corresponding ⩾36 weeks of gestation children.

Conclusions:

Approximately 1 in 7 children with CP born at 32 to 35 weeks had a history suggestive of birth asphyxia. They had different magnetic resonance imaging patterns of injury from those born at ⩾36 weeks and a higher frequency of IVH. Importantly, when considering hypothermia in preterm neonates with suspected birth asphyxia, prospective surveillance for IVH will be essential.

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Acknowledgements

The Canadian Cerebral Palsy Registry has been funded by the Réseau de recherche sur le développement, la santé et le bien-être de l'enfant (RSDE) des Fonds de Recherche en Santé du Québec (FRSQ) and Kids Brain Health Network, a Network of Centres of Excellence. No funding sources were involved in the design, analysis, manuscript preparation or manuscript submission decisions of this study.

Canadian Cerebral Palsy Registry

John Andersen6, David Buckley7, Darcy Fehlings8, Adam Kirton9, Alison Moore10, Esias van Rensburg11, Ellen Wood12

6Glenrose Rehabilitation Hospital, Edmonton, AB; 7Janeway Children’s Hospital, St. John’s, NL; 8Bloorview Kids Rehab, Toronto, ON; 9Alberta Children's Hospital, Calgary, AB; 10Alberta Children's Hospital, Calgary, AB; 11Children’s Hospital, Vancouver, BC; 12IWK Health Centre, Halifax, NS.

Author information

Author notes

  1. J Garfinkle, P Wintermark, M I Shevell and M Oskoui: Members of the Canadian Cerebral Palsy Registry are listed before references.

Authors and Affiliations

  1. Department of Pediatrics, McGill University, Montreal, QC, Canada

    J Garfinkle, P Wintermark & M I Shevell

  2. Division of Newborn Medicine, McGill University Health Center, Montreal, QC, Canada

    P Wintermark

  3. Department of Neurology/Neurosurgery, McGill University, Montreal, QC, Canada

    M I Shevell

  4. Division of Pediatric Neurology, McGill University Health Centre, Montreal, QC, Canada

    M I Shevell

  5. Departments of Pediatrics and Neurology and Neurosurgery, McGill University, Montréal, QC, Canada

    M Oskoui

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on behalf of the Canadian Cerebral Palsy Registry

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Correspondence to M Oskoui.

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Garfinkle, J., Wintermark, P., Shevell, M. et al. Children born at 32 to 35 weeks with birth asphyxia and later cerebral palsy are different from those born after 35 weeks. J Perinatol 37, 963–968 (2017). https://doi.org/10.1038/jp.2017.23

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