Neonatal well-being and timing of brain injury in persons with cerebral palsy born at term or late preterm

Susan M Reid; Gina L Hinwood; Angela T Guzys; Rod W Hunt; Dinah S Reddihough

doi:10.1111/dmcn.15829

Neonatal well-being and timing of brain injury in persons with cerebral palsy born at term or late preterm

Dev Med Child Neurol. 2023 Dec 18. doi: 10.1111/dmcn.15829. Online ahead of print.

Authors

Susan M Reid^{1

2

3}, Gina L Hinwood^{1

4

5}, Angela T Guzys¹, Rod W Hunt^{6

7

8}, Dinah S Reddihough^{1

2

3}

Affiliations

¹ Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
² Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
³ Neurodevelopment and Disability, The Royal Children's Hospital, Parkville, Victoria, Australia.
⁴ Victorian Paediatric Rehabilitation Service, Monash Children's Hospital, Clayton, Victoria, Australia.
⁵ Department of Perinatal Medicine, The Mercy Hospital for Women, Heidelberg, Victoria, Australia.
⁶ Department of Paediatrics, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
⁷ Monash Newborn, Monash Health, Clayton, Victoria, Australia.
⁸ Cerebral Palsy Alliance, University of Sydney, New South Wales, Australia.

PMID: 38111136
DOI: 10.1111/dmcn.15829

Abstract

Aim: To describe the distribution of neuroimaging patterns in a term/late preterm population-based cohort with cerebral palsy (CP), ascertain associations between neuroimaging patterns and neonatal well-being, estimate the proportion with antenatal or perinatal timing of neuropathology, and apply this information to the understanding of common mechanisms of brain injury and causal pathways.

Method: The cohort for this observational study comprised 1348 persons born between 1999 and 2017 in Victoria, Australia. Using algorithms designed for the study, neonatal well-being and timing of brain injury were tabulated for the whole cohort and across neuroimaging patterns and birth epochs.

Results: Clinical and demographic profiles, neonatal well-being, and timing of brain injury differed across neuroimaging patterns. An estimated 57% of the cohort had a complicated neonatal period. Timing of brain injury was antenatal in 57% and perinatal in 41%. A decrease in the relative proportions of perinatal timing of brain injury was observed over a period when the rates of CP in live births at term decreased.

Interpretation: This study begins to bridge the knowledge gap about causation in CP, moving towards better description of the main mechanisms of brain injury and their contribution within CP cohorts, and facilitating the ability to monitor changes over time and the success of preventive measures.

Abstract

Grants and funding