Bashiri Asher, Burstein Eliezer, Mazor Moshe
Department of Obstetrics and Gynecology, Soroka University Medical Center, PO Box 151, Beer-Sheva, Israel.
J Perinat Med. 2006;34(1):5-12. doi: 10.1515/JPM.2006.001.
Cerebral palsy (CP) is the most common cause of severe physical disability in childhood. The precise etiological factor for the development of the majority of cases of CP has not been identified, however, prematurity is considered to be the leading identifiable risk factor. During the last decade, intrauterine infection/inflammation has been identified as the most common cause of preterm delivery and neonatal complications. When microorganisms or their products gain access to the fetus they stimulate the production of cytokines and a systemic response termed FIRS (Fetal Inflammatory Response Syndrome). Subsequently, FIRS was implicated as a cause of fetal or neonatal injury that leads to CP and chronic lung disease. Several authors found an increase in the risk for CP in infants born to mothers with clinical chorioamnionitis, especially in preterm neonates. A relationship between CP and intra-amniotic inflammation was demonstrated, intrauterine infection may lead to activation of the cytokine network which in turn can cause white matter brain damage and preterm delivery, as well as the future development of CP. This white matter insult is identified clinically as periventricular leucomalacia (PVL) which is associated with the subsequent development of impaired neurological outcomes of variable severity including CP.
脑瘫（CP）是儿童期严重身体残疾的最常见原因。然而，大多数脑瘫病例的确切病因尚未明确，不过早产被认为是主要的可识别风险因素。在过去十年中，宫内感染/炎症已被确定为早产和新生儿并发症的最常见原因。当微生物或其产物进入胎儿体内时，它们会刺激细胞因子的产生以及一种称为胎儿炎症反应综合征（FIRS）的全身反应。随后，FIRS被认为是导致胎儿或新生儿损伤从而引发脑瘫和慢性肺病的原因。几位作者发现，患有临床绒毛膜羊膜炎的母亲所生婴儿患脑瘫的风险增加，尤其是早产新生儿。脑瘫与羊膜腔内炎症之间的关系得到了证实，宫内感染可能导致细胞因子网络激活，进而可引起脑白质损伤、早产以及未来脑瘫的发生。这种脑白质损伤在临床上被识别为脑室周围白质软化（PVL），它与随后出现的包括脑瘫在内的不同严重程度的神经功能障碍的发展有关。
