Cerebral palsy in preterm infants
Cerebral palsy in preterm infants
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DOI：
10.2298/vsp140321019d
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发表时间：
2016-04-01
影响因子：
0.2
通讯作者：
Krasnik, Rastislava
中科院分区：
文献类型：
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作者：
Drljan, Cila Demesi;Mikov, Aleksandra;Krasnik, Rastislava
背景/目标。脑性瘫痪（CP）是儿童期神经功能障碍的主要原因之一。早产是CP发生的重要危险因素。临床结局可能包括粗大运动功能和智力障碍、视力障碍和癫痫。本研究的目的是探讨胎龄、脑瘫类型、功能能力和相关疾病之间的关系。方法.样本量为206名CP儿童。资料来源于医疗记录，包括出生时的胎龄、CP的临床特征和相关情况。根据欧洲脑性瘫痪监测（SCPE）和地形图确定临床CP类型。根据粗大运动功能分类系统（GMFCS）评估粗大运动功能能力。结果超过一半的CP患儿早产（54.4%）。不同临床类型CP的分布与胎龄的关系有统计学显著性差异（p < 0.001）。在痉挛型双侧CP组中，早产儿的比例更高。在基于GMFCS的功能分类中，在胎龄方面注意到统计学显著差异（p = 0.049），在较早胎龄出生的儿童被分类在较高的GMFCS功能限制水平。受两种或两种以上相关疾病影响的儿童比例最高（70.0%）是在极早产组中发现的，并且随着出生时成熟度的增加，这一数字有所下降。癫痫在较大胎龄出生的儿童中更普遍，这种分布差异具有统计学意义（p = 0.032）。结论早产儿产前和产后保护的应用应是CP预防策略的重要组成部分。
Background/Aim. Cerebral palsy (CP) is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy) in Europe (SCPE) and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS). Results. More than half of the children with CP were born prematurely (54.4%). Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001). In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049), children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0%) affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032). Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy.