Suzuki Kai, Husein Nafisa, Oskoui Maryam, Fehlings Darcy, Shevell Michael, Kirton Adam, Dunbar Mary J
Department of Neuroscience, University of Calgary, Calgary, AB, Canada.
Research Institute-McGill University Health Centre, Montreal, QC, Canada.
Dev Med Child Neurol. 2025 Apr;67(4):475-485. doi: 10.1111/dmcn.16111. Epub 2024 Oct 15.
To compare, in term-born children with cerebral palsy (CP), the characteristics of those who exhibit detectable risk factors for CP at birth with those who do not.
This was a cross-sectional study of term-born children using the Canadian Cerebral Palsy Registry comparing those with and without perinatal risk factors and/or neonatal symptoms for pregnancy, birth and neonatal characteristics, magnetic resonance imaging (MRI) findings, CP subtype, and impairment severity. Risk factors were quantified with a CP risk calculator. Multivariable and multinomial regressions were expressed as odds ratios (OR) and relative risk ratios.
Of 1333 term-born children, 781 (58.6%) had complete variables for the CP risk calculator, of whom 195 (25%) had 'undetectable' newborn infant CP risk, and they did not have greater postneonatal brain injury. Focal injury on MRI was more common (OR 2.0, 95% confidence interval [CI] 1.3-3.1) than in the 'detectable' group. The 'undetectable' group had more unilateral CP (OR 1.8, 95% CI 1.3-2.6), less severe motor impairment (OR 0.76, 95% CI 0.67-0.86), and were more verbal (OR 2.3, 95% CI 1.5-3.6).
In the Canadian CP Registry, one-quarter of term-born children lacked neonatal encephalopathy, seizures, or perinatal risk factors. They were more likely to have unilateral CP, focal MRI findings, and communicate with words than children with risk factors or neonatal symptoms.
比较足月儿脑瘫（CP）患儿中，出生时存在可检测到的CP危险因素的患儿与不存在此类因素的患儿的特征。
这是一项对足月儿的横断面研究，使用加拿大脑瘫登记处的数据，比较有无围产期危险因素和/或新生儿症状的患儿在妊娠、出生及新生儿特征、磁共振成像（MRI）结果、CP亚型和损伤严重程度方面的差异。危险因素通过CP风险计算器进行量化。多变量和多项回归以比值比（OR）和相对风险比表示。
在1333名足月儿中，781名（58.6%）具备CP风险计算器所需的完整变量，其中195名（25%）新生儿CP风险“不可检测”，且他们没有更严重的新生儿期后脑损伤。MRI上的局灶性损伤比“可检测”组更常见（OR 2.0，95%置信区间[CI] 1.3 - 3.1）。“不可检测”组单侧CP更多（OR 1.8，95% CI 1.3 - 2.6），运动损伤较轻（OR 0.76，95% CI 0.67 - 0.86），且语言能力更强（OR 2.3，95% CI 1.5 - 3.6）。
在加拿大CP登记处，四分之一的足月儿没有新生儿脑病、癫痫或围产期危险因素。与有危险因素或新生儿症状的患儿相比，他们更易患单侧CP、MRI有局灶性表现，且能用言语交流。
