Photo Credit: Herraez

The following is a summary of “Increasing Prevalence of Cerebral Palsy Among Two-year-Old Children Born at <27 Weeks of Gestation: A Cohort Study,” published in the February 2024 issue of Pediatrics by DeMauro et al.

This retrospective cohort study aimed to assess the evolving prevalence and severity of cerebral palsy (CP) among surviving children born at <27 weeks of gestation and to elucidate associations between CP and various developmental domains, functional impairment, medical morbidities, and resource utilization in two-year-old children born extremely preterm.

Data were derived from a prospective registry spanning 25 Eunice Kennedy Shriver NICHD Neonatal Research Network centers. Participants included children born at <27 weeks of gestation, tracked from 18 to 26 months corrected age (CA) between 2008 and 2019. Outcomes examined encompassed changes in CP prevalence and severity over time, alongside associations between CP and neurodevelopmental outcomes, functional impairment, and medical comorbidities. Adjusted logistic, linear, multinomial logistic, and robust Poisson regression models were utilized to evaluate relationships between child characteristics, CP severity, and outcomes.

Among 6,927 surviving children with complete follow-up data, 3,717 (53.7%) exhibited normal neurologic examinations, while 1,303 (18.8%) were diagnosed with CP. Adjusted rates of CP increased progressively each year throughout the study period (adjusted odds ratio [aOR] 1.11 per year, 95% CI 1.08-1.14). Notably, cognitive development showed significant associations with CP severity. Furthermore, children with CP demonstrated a heightened likelihood of experiencing multiple medical comorbidities, neurosensory issues, and growth deficiencies at follow-up.

The prevalence of CP among surviving children born extremely preterm displayed an upward trend from 2008 to 2019. At 18 to 26 months of CA, both neurodevelopmental and medical comorbidities were markedly associated with all severity levels of CP, underscoring the multifaceted impact of CP in this vulnerable population.

 Source: sciencedirect.com/science/article/abs/pii/S0022347624000477