Risk factors for cerebral palsy and movement difficulties in 5-year-old children born extremely preterm.

Autor: Aubert AM; Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004, Paris, France. adrien.aubert@inserm.fr., Costa R; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal.; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal., Johnson S; Department of Population Health Sciences, University of Leicester, Leicester, UK., Ådén U; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.; Department of Bioclinical Sciences, Linköping University, Linköping, Sweden., Cuttini M; Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy., Koopman-Esseboom C; Department of Neonatology, University Medical Center, Utrecht, The Netherlands., Lebeer J; Department of Medicine & Population Health, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium., Varendi H; University of Tartu, Tartu University Hospital, Tartu, Estonia., Zemlin M; Department of General Pediatrics and Neonatology, Saarland University Hospital, 66421, Homburg, Germany., Pierrat V; Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004, Paris, France.; Department of Neonatology, CHI Créteil, Créteil, France., Zeitlin J; Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004, Paris, France.
Jazyk: angličtina
Zdroj: Pediatric research [Pediatr Res] 2023 Aug; Vol. 94 (2), pp. 771-780. Date of Electronic Publication: 2023 Jan 24.
DOI: 10.1038/s41390-022-02437-6
Abstrakt: Background: Motor impairment is common after extremely preterm (EPT, <28 weeks' gestational age (GA)) birth, with cerebral palsy (CP) affecting about 10% of children and non-CP movement difficulties (MD) up to 50%. This study investigated the sociodemographic, perinatal and neonatal risk factors for CP and non-CP MD.
Methods: Data come from a European population-based cohort of children born EPT in 2011-2012 in 11 countries. We used multinomial logistic regression to assess risk factors for CP and non-CP MD (Movement Assessment Battery for Children - 2nd edition ≤5th percentile) compared to no MD (>15th percentile) among 5-year-old children.
Results: Compared to children without MD (n = 366), young maternal age, male sex and bronchopulmonary dysplasia were similarly associated with CP (n = 100) and non-CP MD (n = 224) with relative risk ratios (RRR) ranging from 2.3 to 3.6. CP was strongly related to severe brain lesions (RRR >10), other neonatal morbidities, congenital anomalies and low Apgar score (RRR: 2.4-3.3), while non-CP MD was associated with primiparity, maternal education, small for GA (RRR: 1.6-2.6) and severe brain lesions, but at a much lower order of magnitude.
Conclusion: CP and non-CP MD have different risk factor profiles, with fewer clinical but more sociodemographic risk factors for non-CP MD.
Impact: Young maternal age, male sex and bronchopulmonary dysplasia similarly increased risks of both cerebral palsy and non-cerebral palsy movement difficulties. Cerebral palsy was strongly related to clinical risk factors including severe brain lesions and other neonatal morbidities, while non-cerebral palsy movement difficulties were more associated with sociodemographic risk factors. These results on the similarities and differences in risk profiles of children with cerebral palsy and non-cerebral palsy movement difficulties raise questions for etiological research and provide a basis for improving the identification of children who may benefit from follow-up and early intervention.
(© 2023. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)
Databáze: MEDLINE
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