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Randomized Controlled Trial
. 2013 Oct;132(4):e905-14.
doi: 10.1542/peds.2012-3915. Epub 2013 Sep 9.

Cerebral palsy and growth failure at 6 to 7 years

Betty R Vohr  1 , Bonnie E Stephens, Scott A McDonald, Richard A Ehrenkranz, Abbot R Laptook, Athina Pappas, Susan R Hintz, Seetha Shankaran, Rosemary D Higgins, Abhik Das; Extended Hypothermia Follow-up Subcommittee of the NICHD Neonatal Research Network
Collaborators, Affiliations
Randomized Controlled Trial

Cerebral palsy and growth failure at 6 to 7 years

Betty R Vohr et al. Pediatrics. 2013 Oct.

Abstract

Objective: To evaluate the association between severity of cerebral palsy (CP) and growth to 6 to 7 years of age among children with moderate to severe (Mod/Sev) hypoxic ischemic encephalopathy (HIE). It was hypothesized that children with Mod/Sev CP would have poorer growth, lower cognitive scores, and increased rehospitalization rates compared with children with no CP (No CP).

Methods: Among 115 of 122 surviving children followed in the hypothermia trial for neonatal HIE, growth parameters and neurodevelopmental status at 18 to 22 months and 6 to 7 years were available. Group comparisons (Mod/Sev CP and No CP) with unadjusted and adjusted analyses for growth <10th percentile and z scores by using Fisher's exact tests and regression modeling were conducted.

Results: Children with Mod/Sev CP had high rates of slow growth and cognitive and motor impairment and rehospitalizations at 18 to 22 months and 6 to 7 years. At 6 to 7 years of age, children with Mod/Sev CP had increased rates of growth parameters <10th percentile compared with those with No CP (weight, 57% vs 3%; height, 70% vs 2%; and head circumference, 82% vs 13%; P < .0001). Increasing severity of slow growth was associated with increasing age (P < .04 for weight, P < .001 for length, and P < .0001 for head circumference). Gastrostomy feeds were associated with better growth.

Conclusions: Term children with HIE who develop Mod/Sev CP have high and increasing rates of growth <10th percentile by 6 to 7 years of age. These findings support the need for close medical and nutrition management of children with HIE who develop CP.

Trial registration: ClinicalTrials.gov NCT00005772.

Keywords: cerebral palsy; encephalopathy; growth; hypothermia; hypoxia-ischemia.

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Figures

FIGURE 1
FIGURE 1
Study cohort.
FIGURE 2
FIGURE 2
Association of Mod/Sev CP at 6 to 7 years with WT, LT/HT, and HC <10th percentile.
See this image and copyright information in PMC

References

    1. de Vries LS, Jongmans MJ. Long-term outcome after neonatal hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2010;95(3):F220–F224 - PubMed
    1. Gonzalez FF, Miller SP. Does perinatal asphyxia impair cognitive function without cerebral palsy? Arch Dis Child Fetal Neonatal Ed. 2006;91(6):F454–F459 - PMC - PubMed
    1. Guillet R, Edwards AD, Thoresen M, et al. CoolCap Trial Group . Seven- to eight-year follow-up of the CoolCap trial of head cooling for neonatal encephalopathy. Pediatr Res. 2012;71(2):205–209 - PubMed
    1. Marlow N, Rose AS, Rands CE, Draper ES. Neuropsychological and educational problems at school age associated with neonatal encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2005;90(5):F380–F387 - PMC - PubMed
    1. Robertson CMT. Long-term follow-up of term infants with perinatal asphyxia. In: Stevenson DK, Sunshine P, Benitz, WE eds. Fetal and Neonatal Brain Injury. 3rd ed. Cambridge, UK: Cambridge University Press; 2003

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