Clinical profile of children with cerebral palsy born term compared with late- and post-term: a retrospective cohort study

Abstract

Objective: To determine whether cerebral palsy (CP) risks factors, neurological subtype, severity and co-morbidities differ between early/full-term-born children with CP compared with those born late/post-term.

Design: Retrospective cohort study.

Setting: Children with CP born between 1998 and 2014, residing in Canada, and registered in the Canadian Cerebral Palsy Registry (CCPR) (n = 1691), a database with information from 15 participating centres across six Canadian provinces.

Population: Children with CP from the CCPR born at 37 weeks of gestation and later (n = 802).

Methods: The clinical profile of children with CP born at 37-40 weeks of gestation was compared with those born at 41 weeks and later using the Pearson chi-square test (or Fisher's exact test) for univariate analyses of categorical data. A P value <0.05 was considered significant a priori.

Main outcome measures: CP neurological subtype, Gross Motor Function Classification System (GMFCS) severity, risk factors and co-morbidities.

Results: Neonatal encephalopathy was found in 23.9% of children with CP born early/full-term and in 33.6% of those born late/post-term (P = 0.026). Neonatal hyperbilirubinaemia was found in 10.2% of children born in the earlier period and in 2.6% of those born in the later period (P = 0.008). Apgar score at 5 minutes, but not 10 minutes, was significantly higher in the early/full-term group (9) compared with its late/post-term counterpart (7; P = 0.046). Rates of CP subtype, severity (GMFCS) and co-morbidities did not differ significantly between the two gestational periods.

Conclusions: In children with CP, neonatal encephalopathy was significantly less frequent and neonatal hyperbilirubinaemia was significantly more frequent in those born early/full-term compared with their later-born counterparts. However, clinical outcomes of CP were not significantly different between these two gestational epochs.

Tweetable abstract: Children with cerebral palsy born early/full-term have similar outcomes to those born late/post-term.

Keywords: Cerebral palsy; clinical profile; gestational age; post-term; registry; term birth.