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Korean Journal of Obstetrics & Gynecology 2006;49(12):2543-2549.
Published online December 1, 2006.
Clinical characteristics of cerebral palsy following preterm or term birth; 10 years' experience.
Young Ah Koo, Dong Seok Choi, Suk Joo Choi, Soo Young Oh, Yun Sil Chang, Won Soon Park, Hyeon Sook Kim, Cheong Rae Roh, Jong Hwa Kim
1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jh369.kim@samsung.com
2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Department of Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
OBJECTIVE
To investigate the perinatal and clinical characteristics of cerebral palsy (CP) following preterm or term birth. METHODS: A total of 75 infants born and diagnosed as CP in our hospital from October 1994 to December 2004 were recruited retrospectively. Their maternal and perinatal outcomes and the type, involved lesion and severity of CP were analyzed. RESULTS: The incidence of CP was 0.23%, which showed decreasing pattern according to advancing gestational age at birth. CP was more frequent (6.7-times) in multifetal pregnancy. Male to female ratio was 1.5: 1. After excluding five infants with major congenital anomalies, 55 (79%) infants were born before 37 weeks' gestation (preterm CP) and 15 (21%) infants were born beyond 37 weeks' gestation (term CP). Eighty-six percent of preterm CP had significant neonatal morbidities, but only 6 out of 15 infants in term CP had significant perinatal events including hypoxic ischemic encephalopathy, meconium aspiration syndrome, and seizure of unknown origin. The most common type of preterm CP was spastic (95%), whereas the types of term CP were more diverse; spastic in 67%, athetoid in 20%, dystonic in 7%, and hypotonic in 7%. Regarding the involved lesions, the most common type was diplegic in preterm CP and quadriplegic in term CP. CONCLUSION: In contrast to preterm CP, term CP had significantly less perinatal risk factors, and their type and involved lesion showed more diverse patterns. These findings may implicate that more heterogenous etiologies are involved in pathogenesis of term CP.
Key Words: Cerebral palsy, Preterm birth, Term birth, Perinatal risk factors


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