Cerebral palsy in Riyadh, Saudi Arabia: II. Associations between gestational age, birthweight and cerebral palsy.

One hundred and ninety infants with cerebral palsy were studied in Riyadh , Saudi Arabia. Bleeding during pregnancy and toxemic complications seemed to be important causative factors, particularly in preterm and small-for-date infants. Infants born after breech presentation, assisted labour and failed obstetric procedures totalled 20.0% of all cases. Poor feeding, stiffness and infection were the main clinical presentations. Spasticity was the predominant neurological abnormality irrespective of birth weight, with spastic diplegia (31.0%) and quadriplegia (26.3%) contributing greatly to the overall pattern. Speech defects and, to a lesser extent, epilepsy were the most frequent associated handicaps. The majority of children with cerebral palsy (65.8%) were severely handicapped. Saudi Arabia is making rapid economic, social and medical progress, but currently facilities to meet the needs of cerebral palsy victims and their families are inadequate. Based on the above study it is recommended that: (1) paramedical services at community level be initiated; (2) more rehabilitative and educational programs be established; (3) better and more modern obstetric care be provided; (4) close co-operation among the medical professionals be facilitated since cerebral palsy cases can be managed best through a team approach.