We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Cerebral Palsy in Children With Birth Complications

Am J Dis Child. 1988;142(8):814. doi:10.1001/archpedi.1988.02150080020009.
Text Size: A A A
Published online

Sir.—In Table 1 of the recent article by Nelson and Ellenberg,1 I am puzzled by some of the data. The authors report a rate of cerebral palsy of 5.7 per 1000 among children with no birth complications and one neonatal sign. This contrasts with the rate of 2.8 per 1000 among children with birth complications and one neonatal sign. This is counterintuitive: why should children with birth complications have a rate only 50% that of children without birth complications? I note a similar phenomenon in terms of the rate of cerebral palsy per 1000 children having five-minute Apgar scores of 0 to 5 and two neonatal signs (Table 3), where a rate of 0.0 children with cerebral palsy per 1000 is reported. I wonder if selection bias was operating with regard to children who died before follow-up or were unavailable for follow-up? If children with birth complications or low Apgar scores were more likely to be omitted from the follow-up data because of death, this would falsely reduce the apparent risk of cerebral palsy. I would appreciate knowing whether this was investigated by the authors.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.