Cerebral palsy in low-birthweight infants: Etiology and strategies for prevention

Abstract

Premature infants, who now survive in greater numbers than ever before, are at increased risk for motor and other neurologic disabilities. Risk is highest at the lowest extremes of birthweight and gestational age. This article focuses on children born weighing less than 1500 g (those of very low birthweight [VLBW]), almost all of whom are very premature. Maternal infection, especially intrauterine infection, is associated with preterm delivery, increased risk of cerebral palsy (CP), and neonatal brain imaging findings related to CP risk. Administration of magnesium sulfate prenatally, for maternal preeclampsia or for tocolysis, has been associated with reduced risk of CP. Multiple births tend to be low in birthweight, but whether and to what degree VLBW twins and triplets are at additional risk of unfavorable neurologic outcome compared with VLBW singletons of similar birthweight and gestational age is not yet clear. Potential causes and indicators of birth asphyxia are apparently not major factors in CP among VLBW infants. Many but not all the predictors of low birthweight are also predictors of neurologic morbidity among VLBW infants. For example, maternal smoking is related to low or very low birthweight (but not prematurity) and is not related to risk of CP and preeclampsia has been observed in recent studies to be associated with lower CP risk. MRDD Research Reviews 3:112-117, 1997. Published 1997 Wiley-Liss, Inc.1 This article is a US Government work and, as such, is in the public domain in the United States of America.