The asymptomatic newborn and risk of cerebral palsy
K. B. Nelson and J. H. Ellenberg
Neuroepidemiology, Branche, National Institute of Neurological and Communicative Disorders and Stroke, Bethesda, MD 20892.
We investigated whether infants weighing over 2500 g who had experienced
one or more of 14 late pregnancy or birth complications, but who were free
of certain signs in the nursery period were at increased risk of cerebral
palsy (CP). The signs evaluated were decreased activity after the first day
of life, need for incubator care for three or more days, feeding problems,
poor suck, respiratory difficulty, or neonatal seizures. More than 90% of
the infants weighing over 2500 g had none of these signs. In asymptomatic
infants with one or more birth complications, the rate of CP by 7 years of
age was 2.3/1000; among asymptomatic infants whose births were
uncomplicated, the rate of CP was 2.4/1000. The risk for CP rose with
number of abnormal neonatal signs, and children with sustained neonatal
abnormalities were at higher risk than those whose abnormalities were
transient. Most children with CP did not derive from groups at increased
risk. The full-term infant whose birth was complicated but who was free of
certain abnormal signs in the newborn period was not at increased risk of
CP.
