Advanced search

Predictability of cerebral palsy in a high-risk NICU population

Eveline Himpens (UGent) , Ann Oostra (UGent) , Inge Franki (UGent) , Stijn Vansteelandt (UGent) , Piet Vanhaesebrouck (UGent) and Christine Van den Broeck (UGent)
Author
Organization
Abstract
Objective: The aim of this study was to built a model to predict individual risk on the development of cerebral palsy and its characteristics i.e. subtype, distribution and severity of cerebral palsy. Study Design: Retrospective cohort study of high-risk infants. Study Participants and Setting: During an 11-year period (1995 - 2005) 1099 consecutively NICU-admitted high-risk infants were assessed up to the corrected age of at least 2 years. 985 children were eligible for inclusion comprising all children with a GA less than 30 weeks and selected at-risk children with a GA at or above 30 weeks with a complicated neonatal course and/or brain lesion. Methods: Assessment consisted of a detailed physical, neurological and neurodevelopmental examination based on the quality of movement. CP was categorized into spastic or non-pastic, bilateral or unilateral and mild, moderate or severe CP. Univariate and multivariate analyses were performed on infant and perinatal characteristics. The prediction model was evaluated. Results: : Perinatal asphyxia, mechanical ventilation > 7 days, white matter disease except for transient echodensities < 7 days, intraventicular haemorrhage grade 3 and 4, cerebral infarction and deep gray matter lesions were recognised as independent predictors for the development of CP. Gestational age, gender and multiple gestation are, although not significant in the multivariate analyses, added to the risk model. The overall measure of performance of the prediction model is 83.6%. From a predicted chance of 16.5% onwards there is a realistic possibility to develop CP. Gestational age, perinatal asphyxia and deep gray matter lesion are independent predictors in the prediction of non-spastic versus spastic CP (OR= 1.1, 3.6, 7.5). Independent risk factors for unilateral versus bilateral spastic CP are gestational age, cerebral infarction and hemorrhage grade 3 and 4 (OR= 1.1, 31, 4.6, 17.6). Perinatal asphyxia is the only retained predictor for severe versus mild and moderate CP. Conclusion: The presented model provides a firmer basis in the prediction of the individual risk of development of CP in a large cohort of high-risk infant.
Keywords
Predictionmodel, Cerebral Palsy

Citation

Please use this url to cite or link to this publication:

Chicago
Himpens, Eveline, Ann Oostra, Inge Franki, Stijn Vansteelandt, Piet Vanhaesebrouck, and Christine Van den Broeck. 2010. “Predictability of Cerebral Palsy in a High-risk NICU Population.” In Developmental Medicine and Child Neurology, 52:63–63.
APA
Himpens, E., Oostra, A., Franki, I., Vansteelandt, S., Vanhaesebrouck, P., & Van den Broeck, C. (2010). Predictability of cerebral palsy in a high-risk NICU population. DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY (Vol. 52, pp. 63–63). Presented at the 64th Annual meeting of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM).
Vancouver
1.
Himpens E, Oostra A, Franki I, Vansteelandt S, Vanhaesebrouck P, Van den Broeck C. Predictability of cerebral palsy in a high-risk NICU population. DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY. 2010. p. 63–63.
MLA
Himpens, Eveline, Ann Oostra, Inge Franki, et al. “Predictability of Cerebral Palsy in a High-risk NICU Population.” Developmental Medicine and Child Neurology. Vol. 52. 2010. 63–63. Print.
@inproceedings{1996928,
  abstract     = {Objective: The aim of this study was to built a model to predict individual risk on the development of cerebral palsy and its characteristics i.e. subtype, distribution and severity of cerebral palsy.
Study Design: Retrospective cohort study of high-risk infants. 
Study Participants and Setting: During an 11-year period (1995 - 2005) 1099 consecutively NICU-admitted high-risk infants were assessed up to the corrected age of at least 2 years. 985 children were eligible for inclusion comprising all children with a GA less than 30 weeks and selected at-risk children with a GA at or above 30 weeks with a complicated neonatal course and/or brain lesion. 
Methods: Assessment consisted of a detailed physical, neurological and neurodevelopmental examination based on the quality of movement.  CP was categorized into spastic or non-pastic, bilateral or unilateral and mild, moderate or severe CP.  Univariate and multivariate analyses were performed on infant and perinatal characteristics. The prediction model was evaluated.
Results: : Perinatal asphyxia, mechanical ventilation  {\textrangle} 7 days, white matter disease except for transient echodensities {\textlangle} 7 days, intraventicular haemorrhage grade 3 and 4, cerebral infarction and deep gray matter lesions were recognised as independent predictors for the development of CP. Gestational age, gender and multiple gestation are, although not significant in the multivariate analyses, added to the risk model. The overall measure of performance of the prediction model is 83.6\%.  From a predicted chance of 16.5\% onwards there is a realistic possibility to develop CP. Gestational age, perinatal asphyxia and deep gray matter lesion are independent predictors in the prediction of non-spastic versus spastic CP (OR= 1.1, 3.6, 7.5).  Independent risk factors for unilateral versus bilateral spastic CP are gestational age, cerebral infarction and hemorrhage grade 3 and 4 (OR= 1.1, 31, 4.6, 17.6). Perinatal asphyxia is the only retained predictor for severe versus mild and moderate CP. 
Conclusion: The presented  model provides a firmer basis in the prediction of the individual risk of development of CP in a large cohort of high-risk infant.},
  articleno    = {abstract SP6},
  author       = {Himpens, Eveline and Oostra, Ann and Franki, Inge and Vansteelandt, Stijn and Vanhaesebrouck, Piet and Van den Broeck, Christine},
  booktitle    = {DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY},
  issn         = {0012-1622},
  keyword      = {Predictionmodel,Cerebral Palsy},
  language     = {eng},
  location     = {Washington DC, USA},
  number       = {suppl. 5},
  pages        = {abstract SP6:63--abstract SP6:63},
  title        = {Predictability of cerebral palsy in a high-risk NICU population},
  url          = {http://dx.doi.org/10.1111/j.1469-8749.2010.03760.x},
  volume       = {52},
  year         = {2010},
}

Altmetric
View in Altmetric