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August 1988, Vol 142, No. 8 >
Article | August 1988

Cerebral Palsy in Children With Birth Complications-Reply FREE

KARIN B. NELSON, MD; JONAS H. ELLENBERG, PHD
Am J Dis Child. 1988;142(8):814-815. doi:10.1001/archpedi.1988.02150080020010.
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In Reply.—Dr Copian is correct that a higher proportion of infants in the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke (NCPP) study population who had birth complications and low Apgar scores died early and therefore were not candidates for the development of cerebral palsy. That information was presented in an earlier report in JAMA.1 Since our recent report was concerned chiefly with whether a surviving term child with birth complications was at heightened risk for disability if he or she was asymptomatic as a newborn, we did not reexamine the question of mortality.

It would be possible to speculate, for children in this study who died, the effect on the results if they had lived. If the children who died had lived and had had a similar distribution of neonatal signs as the children who really did survive, then the comparative risks of cerebral palsy in the complicated and uncomplicated groups would have remained substantially unchanged. If, on the other hand, a large proportion of the nonsurviving children had lived and had a very high rate of multiple neonatal signs, then the results might have been markedly different. There seems to be no reasonable argument based on NCPP data for a choice of one assumption

REFERENCES

1 +
Nelson KB, Ellenberg JH:  Obstetric complications as risk factors for cerebral palsy or seizure disorders . JAMA 1984;;251:1843-1848.
Link to Article
2 +
Paneth N, Kiely J:  The frequency of cerebral palsy: A review of population studies in industrialised countries since 1950 , in Stanley F, Alberman E (eds): The Epidemiology of the Cerebral Palsies . Oxford, England, Blackwell Scientific Publishers, 1984;, pp 46-56.
3 +
Pharoah POD, Cooke T, Rosenbloom I, et al:  Trends in birth prevalence of cerebral palsy . Arch Dis Child 1987;;62:379-380.
Link to Article
4 +
Jarvis SN, Holloway JS, Hey EN:  Increase in cerebral palsy in normal birthweight babies . Arch Dis Child 1985;;60:1113-1121.
Link to Article
5 +
Hagberg B, Hagberg G, Olow I:  The changing panorama of cerebral palsy in Sweden: IV Epidemiological trends 1959-1978 . Acta Paediatr Scand 1984;;73:433-444.
Link to Article
6 +
Stanley FJ, Watson L:  The cerebral palsies in Western Australia: Trends, 1968 to 1981 . Am J Obstet Gynecol 1988;;158:89-93.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Nelson KB, Ellenberg JH:  Obstetric complications as risk factors for cerebral palsy or seizure disorders . JAMA 1984;;251:1843-1848.
Link to Article
2 +
Paneth N, Kiely J:  The frequency of cerebral palsy: A review of population studies in industrialised countries since 1950 , in Stanley F, Alberman E (eds): The Epidemiology of the Cerebral Palsies . Oxford, England, Blackwell Scientific Publishers, 1984;, pp 46-56.
3 +
Pharoah POD, Cooke T, Rosenbloom I, et al:  Trends in birth prevalence of cerebral palsy . Arch Dis Child 1987;;62:379-380.
Link to Article
4 +
Jarvis SN, Holloway JS, Hey EN:  Increase in cerebral palsy in normal birthweight babies . Arch Dis Child 1985;;60:1113-1121.
Link to Article
5 +
Hagberg B, Hagberg G, Olow I:  The changing panorama of cerebral palsy in Sweden: IV Epidemiological trends 1959-1978 . Acta Paediatr Scand 1984;;73:433-444.
Link to Article
6 +
Stanley FJ, Watson L:  The cerebral palsies in Western Australia: Trends, 1968 to 1981 . Am J Obstet Gynecol 1988;;158:89-93.

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