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 Vol. 7 No. 11, November 2006
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NeoReviews Vol.7 No.11 2006 e575
© 2006 American Academy of Pediatrics

Advances in Understanding Cerebral Palsy Syndromes After Prematurity

Lubov Romantseva, MD*
Michael E Msall, MD*

* University of Chicago Pritzker School of Medicine, Comer Children’s and LaRabida Children’s Hospitals, Section of Developmental and Behavioral Pediatrics, Kennedy Center, and Institute of Molecular Pediatrics, Chicago Ill

The first 300 words of the full text of this article appear below.


   Objectives
 
After completing this article, readers should be able to:

  1. List neonatal morbidities that have been associated with the development of cerebral palsy (CP).
  2. Describe the ultrasonographic findings that are suggestive of CP.
  3. Compare and contrast the use of ultrasonography and magnetic resonance imaging in detecting lesions associated with CP.
  4. Review strategies to adapt the infant neurologic examination to detection of CP.
  5. Explain how the International Classification of Functioning can be used to examine risk and resiliency factors with respect to outcome.
  6. Describe the severity of most cases of CP.


   Introduction
 
During the past 25 years, major advances in maternal-fetal medicine, neonatology, and translational developmental biology have resulted in survival rates exceeding 90% among infants born at weights between 1,000 and 1,499 g, 80% for infants born at weights between 751 and 999 g, and 60% for infants born weighing 500 to 750 g. (1) These birthweight categories approximately reflect appropriate weights for 28 to 32 weeks’, 26 to 27 weeks’, and 23 to 25 weeks’ gestation, respectively. Although survival has improved among these very and extremely preterm infants, prevention of adverse neurodevelopmental outcomes in early childhood among such high-risk survivors as well as other neonatal cohorts receiving new technologies remains a major challenge. (2) The most common early recognized neurodevelopmental impairment is cerebral palsy (CP), and the overall prevalence of this disorder has not decreased over the past 25 years. However, with recent discoveries in brain structure and function, immunology, nutrition, early childhood learning, and developmental plasticity, the future holds promise.

The purpose of this review is to describe risk factors for CP in preterm infants, focusing predominantly on extremely low-birthweight (ELBW) and very low-birthweight infants, but also highlighting gaps in the current knowledge of outcomes among moderately low-birthweight infants. Recent data from multicenter studies emphasize the . . . [Full Text of this Article]






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Copyright © 2006 by the American Academy of Pediatrics.