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Asphyxia and Cerebral Palsy-Reply

Am J Dis Child. 1990;144(8):852-853. doi:10.1001/archpedi.1990.02150320014010.
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In Reply.—Our study used different analytical methods from those employed by Nelson and Ellenberg1 and thereby produced different findings. Nelson and Ellenberg used fetal bradycardia, low Apgar scores, and a delay in a newborn's first cry to identify birth asphyxia. They may have been uncertain about the specificity of these criteria because they did not draw any final conclusions about the number of children in the study who had cerebral palsy (CP) as the result of birth asphyxia. We used specific birth asphyxial disorders that were followed by neonatal seizures to identify asphyxiated neonates. Using these criteria, 9 of the 150 cases of CP in the study could be attributed to birth asphyxia. We found strong indirect evidence that no cases of cerebral palsy due to birth asphyxia were missed in our analyses. We also found that low Apgar scores and several other common clinical consequences of birth


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