Prospective evaluation of perinatal risk factors for cerebral palsy and delayed development in high risk infants

Prematurity, intrauterine infection and perinatal brain injury have been re ported to be significant risk factors of cerebral palsy (CP). We examined t he perinatal predictors of cerebral palsy and delayed development (DD) in 1 84 high risk infants. Thirty-five infants were diagnosed as cerebral palsy and delayed development at 12 months corrected age. Antenatal, intra partum , and neonatal factors were prospectively evaluated in 2 groups of high ris k infants compared with controls, Group A (n=79), infants weighing less tha n 2,000 g; Group B (n=43), infants weighing 2,000 g or more. In univariate analysis, there were no significant antenatal and intrapartum factors assoc iated with cerebral palsy and delayed development in either group. We found that significant postnatal risk factors of CP in group A included sepsis ( p=0.008), BPD (bronchopulmonary dysplasia) (p=0.028), IVH (intraventricular hemorrhage) (p=0.042), ventriculomegaly (VM) (p=0.001) and a longer durati on of mechanical ventilation (p=0.001); while in group B, sepsis (p=0.047) and neonatal seizure (p=0.027) were significant risk factors. In multivaria te analysis, sepsis in group B was a moderate risk factor of CP (OR (odds r atio) 1.47; 95% CI (confidence interval) 1.02-2.13). In conclusion, neonata l sepsis may contribute to the development of cerebral palsy and delayed de velopment. We suggest that high risk infants who have sepsis should be care fully followed for cerebral palsy and delayed development. The prevention o f cerebral palsy may be feasible by decreasing neonatal risk factors such a s sepsis during the neonatal period.