Thursday, September 16, 2010

Cerebral Palsy Risk/ Past due date

FROM MEDICAL NEWS TODAY: An examination of data conducted by Dag Moster, M.D., Ph.D., of the University of Bergen, Norway found that infants entering the world at term or later are associated with an increased risk of cerebral palsy (CP). This JAMA (Journal of the American Medical Association) published study first appeared on September 1, 2010.

CP is the most common cause of physical disability children. Non-progressive disorders of movement and posture are the key symptoms of this prevalent ailment.

Using the Medical Birth Registry of Norway's 1,682,442 births between 1967 and 2001, Moster and colleagues examined the relation of CP risk with gestational age among term and post term births that possessed no congenital anomalies. The group was followed up through 2005 by linkage to other national registries that track Norwegian lifecycles.

1,938 were identified as having cerebral palsy.

The study's authors state:

One of the strongest predictors of CP is preterm birth, with the risk of CP increasing steadily with earlier delivery. Although risk is lower among term births, about three-fourths of all infants with CP are born after 36 weeks. Within this range of term births, there are few data on the possible association of CP with gestational age.
Risk for CP was higher with earlier or later delivery, but those born at the 40 week mark showed almost zero occurrence of CP. Those born at 37 weeks had a 90% increased risk of displaying symptoms of cerebral palsy. At 38 weeks, a 30% higher risk. Forty-two weeks and after deliveries had a 40% increased risk.

Clinicians typically regard term births (37-41 weeks) as low risk, with the possibility of increased risk with post term delivery. This standard definition of term does not correspond well with the period of lowest risk for CP in this study or with the weeks when most infants are born.

Weeks 37 and 38 seem more to resemble weeks 42 and 43, both in CP risk and in the general likelihood of delivery, leaving 39 to 41 weeks as the optimum time for delivery. If the time of delivery affects CP risk, then intervention at 40 weeks might reduce CP risk, while elective delivery at 37 or 38 weeks might increase it.

If infants prone to CP are disrupted in their delivery times, the prevalence of CP would be unchanged regardless of time of delivery.

The research authors finally concluded:

Until the biological mechanisms for these patterns of risk in term and post term births are better understood, it would be hasty to assume that interventions on gestational age at delivery could reduce the occurrence of CP.
FROM NBC: A study suggests babies born past their due date may have an increased risk for cerebral palsy. Although premature birth is a known risk factor for cerebral palsy -- three quarters of babies with the disease are born after 36 weeks of gestation.

Researchers say babies born at at 42 weeks gestation or later had a greater risk of cerebral palsy than babies born closer to their due date -- at 40 weeks.

-NewsAnchorMom Jen

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