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Low and high birthweight increase risk of cerebral palsy

European research published in this week's issue of THE LANCET provides more insight into the association between low birthweight and risk of cerebral palsy. Babies born in the lowest 10% group for birthweight are four to six times more likely to develop cerebral palsy; at the other end of the spectrum, babies born in the top 3% range for birthweight have up to a threefold increased risk.

Cerebral palsy is the most common cause of severe physical disability in children in developed countries. The frequency of the disorder in children born at low birthweights increased sharply around 1980, but the cause of the condition is still poorly understood. Previous research has indicated that low birthweight in term babies is associated with increased risk of cerebral palsy.

Stephen Jarvis from the University of Newcastle, UK, and colleagues compared data from ten European registers for around 4500 children with cerebral palsy born between 1976 and 1990 with the number of births in each study population. Weight and gestational age of these children were compared with reference standards for the normal spread of gestational age and weight-for-gestational age at birth.

Babies of 32-42 weeks' gestation with a birthweight for gestational age below the 10th percentile were 4-6 times more likely to have cerebral palsy than were children in a reference band between the 25th and 75th percentiles. In children with a weight above the 97th percentile, the increased risk was smaller (up to a threefold increase) but was still statistically significant. Babies born with a slightly heavier than average birthweight were at the lowest risk of developing cerebral palsy.

The investigators comment that evidence is pointing to endocrine pathways, infection, coagulation defects, or even a "vanishing twin" episode early in pregnancy as the primary cause in many cases of cerebral palsy.

In an accompanying Commentary (p
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
2-Oct-2003


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