Department of Pediatrics, University of British Columbia and BC Women's Hospital and Health Centre, 4500 Oak St, Vancouver, BC, V6H 3V4, Canada.
Department of Pediatrics, University of British Columbia and BC Women's Hospital and Health Centre, 4500 Oak St, Vancouver, BC, V6H 3V4, Canada.
Early Hum Dev. 2019 Sep;136:7-13. doi: 10.1016/j.earlhumdev.2019.06.009. Epub 2019 Jul 1.
The ability to definitively diagnose cerebral palsy (CP) at 18-24 months is unknown.
To describe very preterm children who, at 19 months, have suspected CP defined as neither having a definitive diagnosis of CP nor no CP and compare them with children with and without CP.
Longitudinal national cohort study of births <29 weeks' gestation with linked Canadian Neonatal Network and Canadian Neonatal Follow-up Network data with 19 month assessments and 3-year questionnaires (Ages and Stages-3 and Health Status Classification System-Preschool). CP, no CP and suspected CP groups, classified at 19 months, were compared using chi square and ANOVA.
Of 3086 survivors, 2280 had complete 19-month corrected age (CA) and 1261 had 3-year CA data. Suspected CP (3.6%), CP (6.4%) and no CP (90%) groups differed (p < 0.05) in birth weight, gestational age, complications of prematurity and NICU length of stay. Children with suspected CP had Bayley-III motor, cognitive and language composite scores at 18 months midway between CP and no CP, had the lowest sensory impairment rates and highest hospital readmission rates. At 3 years, gross motor, fine motor, problem-solving, communication and social skill abilities differed: abnormal outcomes were intermediate for children with suspected CP (p < 0.01).
CP incidence varied from 6.4% to 10% with exclusion or inclusion of children with suspected CP. Children with suspected CP have characteristics mostly midway between those with and without CP and developmental concerns persist to 3 years and require surveillance beyond 19 months.
18-24 个月时明确诊断脑瘫（CP）的能力尚不清楚。
描述在 19 个月时有疑似 CP 的极早产儿，其定义为既没有明确的 CP 诊断，也没有非 CP，并将其与有 CP 和无 CP 的儿童进行比较。
这是一项全国性的纵向队列研究，纳入了胎龄<29 周的新生儿，并与加拿大新生儿网络和加拿大新生儿随访网络的数据相链接，对 19 个月时的评估和 3 岁时的问卷调查（年龄和阶段 3 和健康状况分类系统-学龄前）进行了研究。使用卡方检验和 ANOVA 比较了在 19 个月时分类为 CP、非 CP 和疑似 CP 组的差异。
在 3086 名幸存者中，有 2280 名儿童有完整的 19 个月校正年龄（CA），有 1261 名儿童有 3 岁 CA 数据。疑似 CP（3.6%）、CP（6.4%）和非 CP（90%）三组在出生体重、胎龄、早产儿并发症和新生儿重症监护病房住院时间方面存在差异（p<0.05）。有疑似 CP 的儿童在 18 个月时的贝利 III 运动、认知和语言综合评分处于 CP 和非 CP 之间，感觉障碍率最低，住院再入院率最高。在 3 岁时，粗大运动、精细运动、解决问题、沟通和社交技能能力存在差异：有疑似 CP 的儿童的异常结局处于中间水平（p<0.01）。
CP 的发病率在 6.4%至 10%之间，排除或纳入疑似 CP 儿童时会有所不同。有疑似 CP 的儿童的特征大多介于 CP 和非 CP 之间，发育问题持续到 3 岁，需要在 19 个月后进行监测。
