Esih Katarina, Trunk Tamara, Osredkar Damjan, Verdenik Ivan, Neubauer David, Troha Gergeli Anja, Lučovnik Miha
Department of Pediatric Neurology, University Children's Hospital Ljubljana, University Medical Centre Ljubljana, Slovenia.
Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Early Hum Dev. 2022 Feb;165:105533. doi: 10.1016/j.earlhumdev.2021.105533. Epub 2021 Dec 27.
Cerebral palsy (CP) is a common cause of physical impairment in children, especially in newborns who are small for gestational age (SGA).
The aim of our study was to investigate the association between birth weight and the risk of developing CP, controlling for gestational age and plurality.
This retrospective, observational, case-control study was based on Slovenian Registry of Cerebral Palsy (SRCP) and Slovenian National Perinatal Information System (NPIS) data for the period 2002 to 2010.
For each pregnancy that resulted in the birth of the newborn(s) who later developed CP (n = 254), three pregnancies with newborns who did not develop CP (n = 762) were selected and matched for gestational age and plurality.
Diagnosis of CP was made at age 5 years or older by a developmental pediatrician trained in child neurology or a child neurologist using standard measures.
Risk of CP increased progressively as birth weight percentiles fell below the 50th centile, with children in the lowest percentiles at greatest risk. Birth weight percentiles traditionally classified as SGA were an independent risk factor for developing CP, with an odds ratio of 2.43 (95% confidence interval 1.57, 3.73).
The results of this study suggest that the risk for developing CP is inversely related to birth weight, even at birth weights that do not meet the standard definitions of SGA.
SYNOPSIS - STUDY QUESTION: Does birth weight represent a potential risk factor for the development of cerebral palsy (CP) when controlling for gestational age and plurality?
WHAT'S ALREADY KNOWN: Newborns who are small for gestational age (SGA) are at higher risk of developing CP according to published studies. However, different definitions of SGA (birth weight below the 10th, 5th, or 3rd percentile for gestational age) have been used by researchers and clinicians, making it difficult to compare studies.
This study suggests that the risk of developing CP is inversely related to birth weight, even at birth weights that do not meet standard definitions of SGA.
脑瘫（CP）是儿童身体残疾的常见原因，尤其是在小于胎龄儿（SGA）的新生儿中。
我们研究的目的是调查出生体重与患脑瘫风险之间的关联，同时控制胎龄和多胎情况。
这项回顾性观察性病例对照研究基于2002年至2010年斯洛文尼亚脑瘫登记处（SRCP）和斯洛文尼亚国家围产期信息系统（NPIS）的数据。
对于每一例分娩出后来患脑瘫新生儿的妊娠（n = 254），选择三例分娩出未患脑瘫新生儿的妊娠（n = 762），并根据胎龄和多胎情况进行匹配。
由接受儿童神经学培训的发育儿科医生或儿童神经科医生使用标准方法在5岁及以上时诊断脑瘫。
随着出生体重百分位数降至第50百分位数以下，患脑瘫的风险逐渐增加，处于最低百分位数的儿童风险最高。传统上归类为小于胎龄儿的出生体重百分位数是患脑瘫的独立危险因素，比值比为2.43（95%置信区间1.57, 3.73）。
本研究结果表明，患脑瘫的风险与出生体重呈负相关，即使出生体重未达到小于胎龄儿的标准定义。
综述 - 研究问题：在控制胎龄和多胎情况时，出生体重是否是脑瘫（CP）发生的潜在危险因素？
根据已发表的研究，小于胎龄儿（SGA）的新生儿患脑瘫的风险更高。然而，研究人员和临床医生使用了不同的小于胎龄儿定义（出生体重低于胎龄的第10、第5或第3百分位数），这使得研究之间难以比较。
本研究表明，患脑瘫的风险与出生体重呈负相关，即使出生体重未达到小于胎龄儿的标准定义。
