Cerebral palsy characteristics in term-born children with and without detectable perinatal risk factors: A cross-sectional study.
Kai Suzuki, Nafisa Husein, Maryam Oskoui and 4 others
PMID 39404141WHAT IT FOUND
Term-born children with cerebral palsy and no detectable perinatal risk factors had milder motor and communication impairments than those with risk factors.
They were more likely to have unilateral spastic CP and focal brain injuries, particularly venous stroke, despite normal birth histories.
Key findings
01Children with undetectable neonatal risk had lower motor severity scores and were more likely to be ambulatory and communicate with words than those with detectable risk.
02The undetectable risk group had significantly more unilateral spastic CP and fewer bilateral quadriplegia cases compared to the detectable risk group.
03Focal brain injuries, especially venous strokes, were more common in the undetectable risk group, while deep gray matter and near-total brain injuries were less common.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot establish causality or track development over time. Data was limited by what was available in medical charts, potentially leading to under-documentation of conditions like encephalopathy. MRI analysis was based on textual reports rather than direct image review, and only a subset of reports was reviewed for stroke. There was significant missing data for some variables, such as cord pH, which required multiple imputations that may introduce bias. The 'undetectable' group was smaller (n=195) than the 'detectable' group (n=586), which may affect statistical power for subgroup analyses.
Declared interests
The study was not specifically funded. The Canadian Cerebral Palsy Registry has received funds from the Kids Brain Health Network, the Public Health Agency of Canada, and the Harvey Guyda Chair in Pediatrics Fund. Two authors are funded by the Alberta Children's Hospital Research Institute. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that term-born children with cerebral palsy and no detectable perinatal risk factors have no identifiable brain injury. This study found they had higher rates of focal injuries and venous strokes. Additionally, do not generalize these milder outcomes to all children with CP, as the 'detectable' risk group had more severe bilateral impairments.