A Study of Progression to Cerebral Palsy in Premature Infants with Neurosonographic Abnormal Findings

ABSTRACT

PURPOSE: Although neonatal intensive care and development of obstetrics play a role in improving survival rate in prematurity, cerebral palsy (CP) is still one of the neurologic sequelae. We tried to find what kinds of risk factors in the patients with abnormal neurosonographic findings who developed CP later. This study was performed to predict early enough who will develop CP later and to treat rapidly for rehabilitation. METHODS: The one hundred and forty one infants with intraventricular hemorrhage, cyst, or abnormal increased periventricular echodensity in serial neurosonographic findings were admitted to the neonatal intensive care unit of Gil general hospital from January 1992 to December 1994. Neurosonographic findings in CP group and non-CP group during postpartum 18 months to 54 months were analysed retrospectively. RESULTS: 1) 18 of one hundred and forty one cases with abnormal neurosonographic findings developed CP. The duration of mechanical ventilation of the CP group was 11.6+/-16.1 days. It is significantly shorter than that of the control group (non-CP group 2.2+/-7.0 day). The duration of oxygen therapy in the CP group was 22.4+/-19.2 days. Which is also significantly shorter than that of the control group (non-CP group 5.4+/-8.4 day) (P<0.01). 2) Increased periventricular echodensity and the size of the cyst in neurosonographic findings in the CP group is significantly different from those of the non-CP group P<0.01). 3) In CP group (N=18), Increased periventricular echodensity and cyst formation were located most commonly in the parietal region. 4) The grade of the intraventricular hemorrhage in the CP group was significantly different from that in the non-CP group (P<0.01). 5) The neurosonographic findings give the diagnostic accuracy for predicting CP. CONCLUSIONS: We studied the relationship of the abnormal neurosonographic findings, CP, and associated risk factors. In review, By using neurosonographic examination the risk of the development of CP could be predicted, and by early diagnosis of CP the quality of the life of CP-patient could be better.