Clinical profile of children with cerebral palsy born term compared with late- and post-term: a retrospective cohort study.

Abstract

To determine whether cerebral palsy (CP) risks factors, neurological subtype, severity and co-morbidities differ between early/full-term-born children with CP compared with those born late/post-term. Retrospective cohort study. Children with CP born between 1998 and 2014, residing in Canada, and registered in the Canadian Cerebral Palsy Registry (CCPR) (n = 1691), a database with information from 15 participating centres across six Canadian provinces. Children with CP from the CCPR born at 37 weeks of gestation and later (n = 802). The clinical profile of children with CP born at 37-40 weeks of gestation was compared with those born at 41 weeks and later using the Pearson chi-square test (or Fisher's exact test) for univariate analyses of categorical data. A P value <0.05 was considered significant a priori. CP neurological subtype, Gross Motor Function Classification System (GMFCS) severity, risk factors and co-morbidities. Neonatal encephalopathy was found in 23.9% of children with CP born early/full-term and in 33.6% of those born late/post-term (P = 0.026). Neonatal hyperbilirubinaemia was found in 10.2% of children born in the earlier period and in 2.6% of those born in the later period (P = 0.008). Apgar score at 5 minutes, but not 10 minutes, was significantly higher in the early/full-term group (9) compared with its late/post-term counterpart (7; P = 0.046). Rates of CP subtype, severity (GMFCS) and co-morbidities did not differ significantly between the two gestational periods. In children with CP, neonatal encephalopathy was significantly less frequent and neonatal hyperbilirubinaemia was significantly more frequent in those born early/full-term compared with their later-born counterparts. However, clinical outcomes of CP were not significantly different between these two gestational epochs. Children with cerebral palsy born early/full-term have similar outcomes to those born late/post-term.