Elsevier

Clinics in Perinatology

Volume 27, Issue 2, 1 June 2000, Pages 285-302
Clinics in Perinatology

ANTECEDENTS OF CEREBRAL PALSY IN VERY LOW–BIRTH WEIGHT INFANTS

https://doi.org/10.1016/S0095-5108(05)70022-1Get rights and content

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Genetic Factors

Although many genetic syndromes are associated with CP, as a group they are rare and account for only a small proportion of cases.63 The most important genetic influences probably are those that predispose a woman to deliver prematurely.98 If, as discussed later, an inflammatory cytokine cascade is causally related to both preterm birth and CP,36 then genetic influences on the inflammatory response may constitute an inherited determinant of CP risk.32

Prepregnancy Factors

In studies restricted to preterm or VLBW

SUMMARY

Research from the last two decades provides directions for efforts to prevent CP in VLBW infants. The pathogenesis of CP seems to involve factors operating both during pregnancy and in the neonatal period. The most important prenatal factor appears to be intrauterine infection. Perinatal infection and other risk factors, such as the death of a co-twin, placental abruption, and cerebral ischemia, could trigger a cytokine cascade resulting in damage to the developing brain. The low frequency of

ACKNOWLEDGMENTS

The authors acknowledge the support and advice of Alan Leviton, MD. Dr. O'Shea acknowledges the support and advice of Robert Dillard, MD, and Kurt Klinepeter, MD.

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    The authors thank the North Carolina Department of Environment, Health, and Natural Resources and the Brenner Children's Hospital (Dr. O'Shea) and the United Cerebral Palsy Research and Educational Foundation (EH-003-98) (Dr. Dammann).

    Address reprint requests to T. Michael O'Shea, MD, MPH Department of Pediatrics Wake Forest University School of Medicine Medical Center Boulevard Winston-Salem, NC 27157

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