Intrauterine growth and survival in cerebral palsy

Hemming, K.; Hutton, J. L.; Bonellie, S.; Kurinczuk, J. J.
March 2008
Archives of Disease in Childhood -- Fetal & Neonatal Edition;Mar2008, Vol. 93 Issue 2, pF121
Academic Journal
Background and objectives: Deviations in birth weight from an optimum, thought to be just above average for gestational age, are known to increase both the risk of developing cerebral palsy and the risk of developing cerebral palsy of a more severe form. Influences on survival of such deviations from average birth weight for gestational age are not known. Methods: Using a well-established, well-defined and large UK cohort of children and adults with cerebral palsy, followed from birth for nearly 25 years, we investigate the influence of deviations from average birth weight for gestational age, on survival duration, after allowing for severity of impairments. Results: A total of 3946 cases, born between 1980 and 1996 were included. For those born much lighter than average for gestational age, more than 30% (n = 313) had a severe motor or cognitive impairment, rising to as much as 40% (n = 239) for extremely low weights. For female infants, the proportions severely impaired increased to as much as 35% (n = 49) among those born much heavier than average; no such increase was observed for heavier than average male infants. For those with four severe impairments and a birth weight close to average for gestational age, around 60% (n = 140) survived to age 15 years, compared with less than 40% (n = 9) of those born much heavier than average for gestational age. A 2-year-old child with four severe impairments and born heavy for gestational age has a predicted median life expectancy of 79% (95% CI 70% to 88%) of the average. Conclusions: Infants with a birth weight lighter than average for gestational age have an increased likelihood of developing a more severe form of cerebral palsy. Surprisingly, among the infants who are very severely impaired, those born much lighter than average for gestational age have the longest life expectancy, and those born much heavier than average for gestational age have the shortest life expectancy.


Related Articles

  • Hb A1c in relation to intrauterine growth among male adolescents in southern Brazil. Nazmi, A.; Huttly, S. R.; Victora, C. G.; Lima, R. C.; Post, P. R.; Elizalde, J. W. L.; Gerson, B. M. C. // European Journal of Clinical Nutrition;Mar2007, Vol. 61 Issue 3, p434 

    The fetal origins hypothesis states that nutritional deprivation in utero affects fetal development and contributes to the incidence of diseases associated with the metabolic syndrome in later life. This study investigated whether haemoglobin (Hb) A1c, an indicator of blood glucose, varied among...

  • Familial Aggregation of Fetal Growth Restriction in a French Cohort of 7,822 Term Births between 1971 and 1985. Batide-Alanore, Agnès La; Trégouët, David-Alexandre; Jaquet, Delphine; Bouyer, Jean; Tiret, Laurence // American Journal of Epidemiology;Jul2002, Vol. 156 Issue 2, p180 

    An association between fetal growth restriction and increased rates of metabolic and cardiovascular diseases in adulthood has been reported. This study evaluated familial aggregation of fetal growth restriction in term births. The population consisted of 3,505 sibships comprised of 7,822...

  • CHANGES IN MULTIPLE LIVE BIRTHS AND CEREBRAL PALSY CHILDREN OVER TIME IN EUROPE (1980-1996). Cans, C.; Topp, M.; Gliniabaua, S.; Johnson, A.; Platt, M. J. // Journal of Epidemiology & Community Health;Aug2004 Supplement 1, Vol. 58, pA13 

    The article studies the trends over time of the rate of Cerebral Palsy (CP) in children issuing from Multiple births and whether multiples with CP changed over time with regard to their gestational age (GA), birth weight (BW), and clinical features. Results suggests that despite an increase in...

  • small for gestational age.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p2145 

    A definition of the term "small for gestational age," which may refer to the term describing an infant whose birth weight is at or below the 10th percentile, as correlated with the number of weeks in utero on the intrauterine growth chart, or a fetus that is more than two standard deviations...

  • Růst a pubertální vývoj u dÄ•tí s intrauterinní růstovou retardací v moravské vÄ•tvi studie ELSPAC. Novotná, D.; Doležel, Z.; Lebl, J.; Kukla, L.; Okrajek, P. // Czecho-Slovak Pediatrics / Cesko-Slovenska Pediatrie;Feb2012, Vol. 67 Issue 2, p75 

    Intrauterine growth restriction (IUGR) may be linked to short adult height. Some data suggest that early start or rapid progress of puberty can aggravate final short stature. We aimed to compare the current height, final height predicted according to Bayley-Pinneau and course of puberty in...

  • Racial and Ethnic Differences in Determinants of Intrauterine Growth Retardation and Other Compromised Birth Outcomes. Frisbie, W. Parker; Biegler, Monique; De Turk, Peter; Forbes, Douglas; Pullum, Starling G. // American Journal of Public Health;Dec1997, Vol. 87 Issue 12, p1977 

    Objectives. This study examined the extent of variation by race/ethnicity in the prevalence of adverse birth outcomes, whether differentials persisted after other risk factors were controlled for, and whether the direction and magnitude of relationships differed by type of outcome. Methods. A...

  • The Missing Data Problem in Birth Weight Percentiles and Thresholds for "Small-for-Gestational-Age". Jennifer A. Hutcheon; Robert W. Platt // American Journal of Epidemiology;Apr2008, Vol. 167 Issue 7, p786 

    Weight-for-gestational-age charts and definitions of “small-for-gestational-age” based on the distribution of livebirths at a given gestational age have conventionally been used to identify infants whose fetal growth is poor. However, references based on the weights of only...

  • Preterm Birth, Intrauterine Growth Retardation, and Perinatal Mortality. Kiely, John L.; Susser, Mervyn // American Journal of Public Health;Mar1992, Vol. 82 Issue 3, p343 

    The article discusses a report on the association of perinatal mortality with gestational age and birth weight, published within the issue. Preterm birth and intrauterine growth retardation (IUGR) often occur together, but IUGR in full-term births yields an exclusive category. The authors assert...

  • Associated Factors for Accelerated Growth in Childhood: A Systematic Review. Chrestani, Maria; Santos, Iná; Horta, Bernardo; Dumith, Samuel; Oliveira Dode, Maria // Maternal & Child Health Journal;Apr2013, Vol. 17 Issue 3, p512 

    Several studies have shown that accelerated growth in the postnatal period is critical for the development of chronic diseases. The term catch- up has been used for the accelerated growth of children who have suffered some sort of restriction of nutrition or oxygen supply. However, accelerated...


Read the Article


Sign out of this library

Other Topics