Cerebral palsy and growth failure at 6 to 7 years
Betty R Vohr, Bonnie E Stephens, Scott A McDonald, Richard A Ehrenkranz, Abbot R Laptook, Athina Pappas, Susan R Hintz, Seetha Shankaran, Rosemary D Higgins, Abhik Das, Extended Hypothermia Follow-up Subcommittee of the NICHD Neonatal Research Network, Richard A Ehrenkranz, Susan R Hintz, Athina Pappas, Jon E Tyson, Betty R Vohr, Kimberly Yolton, Abhik Das, Rosemary D Higgins, Rebecca Bara, Alan H Jobe, Michael S Caplan, Theresa M Leach, William Oh, Angelita M Hensman, Lucy Noel, Victoria E Watson, Michele C Walsh, Avroy A Fanaroff, Deanne E Wilson-Costello, Nancy Bass, Harriet G Friedman, Nancy S Newman, Bonnie S Siner, Kurt Schibler, Edward F Donovan, Kimberly Yolton, Kate Bridges, Jean J Steichen, Barbara Alexander, Cathy Grisby, Holly L Mincey, Jody Hessling, Teresa L Gratton, Ronald N Goldberg, C MichaelCotten, Ricki F Goldstein, Kathryn E Gustafson, Kathy J Auten, Katherine A Foy, Kimberley A Fisher, Sandy Grimes, Melody B Lohmeyer, David P Carlton, Lucky Jain, Ann M Blackwelder, Ellen C Hale, Sobha Fritz, Linda L Wright, Elizabeth M McClure, Stephanie Wilson Archer, Brenda B Poindexter, James A Lemons, Diana D Appel, Jessica Bissey, Dianne E Herron, Lucy C Miller, Leslie Richard, Leslie Dawn Wilson, W Kenneth Poole, Jeanette O'Donnell Auman, Margaret Cunningham, Jane Hammond, Betty K Hastings, Jamie E Newman, Carolyn M Petrie Huitema, Scott E Schaefer, Kristin M Zaterka-Baxter, Krisa P Van Meurs, Susan R Hintz, David K Stevenson, M Bethany Ball, Maria Elena DeAnda, Waldemar A Carlo, Namasivayam Ambalavanan, Myriam Peralta- Carcelen, Kathleen G Nelson, Monica V Collins, Shirley S Cosby, Vivien A Phillips, Laurie Lou Smith, Neil N Finer, David Kaegi, Maynard R Rasmussen, Yvonne E Vaucher, Martha G Fuller, Kathy Arnell, Chris Henderson, Wade Rich, Shahnaz Duara, Charles R Bauer, Sylvia Hiriart-Fajardo, Mary Allison, Maria Calejo, Ruth Everett-Thomas, Silvia M Frade Eguaras, Susan Gauthier, Dale L Phelps, Gary J Myers, Ronnie Guillet, Diane Hust, Linda J Reubens, Pablo J Sánchez, R Sue Broyles, Abbot R Laptook, Charles R Rosenfeld, Walid A Salhab, Roy J Heyne, Cathy Boatman, Cristin Dooley, Gaynelle Hensley, Jackie F Hickman, Melissa H Leps, Susie Madison, Nancy A Miller, Janet S Morgan, Lizette E Torres, Alicia Guzman, Jon E Tyson, Kathleen A Kennedy, Esther G Akpa, Claudia I Franco, Anna E Lis, Georgia E McDavid, Patti L Pierce Tate, Nora I Alaniz, Magda Cedillo, Susan Dieterich, Patricia W Evans, Charles Green, Margarita Jiminez, Terri Major-Kincade, Brenda H Morris, M Layne Poundstone, Stacey Reddoch, Saba Siddiki, Maegan C Simmons, Laura L Whitely, Sharon L Wright, Athina Pappas, Yvette R Johnson, Rebecca Bara, Laura A Goldston, Geraldine Muran, Deborah Kennedy, Patrick J Pruitt, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Elaine Romano, Joanne Williams, Susan DeLancy, Betty R Vohr, Bonnie E Stephens, Scott A McDonald, Richard A Ehrenkranz, Abbot R Laptook, Athina Pappas, Susan R Hintz, Seetha Shankaran, Rosemary D Higgins, Abhik Das, Extended Hypothermia Follow-up Subcommittee of the NICHD Neonatal Research Network, Richard A Ehrenkranz, Susan R Hintz, Athina Pappas, Jon E Tyson, Betty R Vohr, Kimberly Yolton, Abhik Das, Rosemary D Higgins, Rebecca Bara, Alan H Jobe, Michael S Caplan, Theresa M Leach, William Oh, Angelita M Hensman, Lucy Noel, Victoria E Watson, Michele C Walsh, Avroy A Fanaroff, Deanne E Wilson-Costello, Nancy Bass, Harriet G Friedman, Nancy S Newman, Bonnie S Siner, Kurt Schibler, Edward F Donovan, Kimberly Yolton, Kate Bridges, Jean J Steichen, Barbara Alexander, Cathy Grisby, Holly L Mincey, Jody Hessling, Teresa L Gratton, Ronald N Goldberg, C MichaelCotten, Ricki F Goldstein, Kathryn E Gustafson, Kathy J Auten, Katherine A Foy, Kimberley A Fisher, Sandy Grimes, Melody B Lohmeyer, David P Carlton, Lucky Jain, Ann M Blackwelder, Ellen C Hale, Sobha Fritz, Linda L Wright, Elizabeth M McClure, Stephanie Wilson Archer, Brenda B Poindexter, James A Lemons, Diana D Appel, Jessica Bissey, Dianne E Herron, Lucy C Miller, Leslie Richard, Leslie Dawn Wilson, W Kenneth Poole, Jeanette O'Donnell Auman, Margaret Cunningham, Jane Hammond, Betty K Hastings, Jamie E Newman, Carolyn M Petrie Huitema, Scott E Schaefer, Kristin M Zaterka-Baxter, Krisa P Van Meurs, Susan R Hintz, David K Stevenson, M Bethany Ball, Maria Elena DeAnda, Waldemar A Carlo, Namasivayam Ambalavanan, Myriam Peralta- Carcelen, Kathleen G Nelson, Monica V Collins, Shirley S Cosby, Vivien A Phillips, Laurie Lou Smith, Neil N Finer, David Kaegi, Maynard R Rasmussen, Yvonne E Vaucher, Martha G Fuller, Kathy Arnell, Chris Henderson, Wade Rich, Shahnaz Duara, Charles R Bauer, Sylvia Hiriart-Fajardo, Mary Allison, Maria Calejo, Ruth Everett-Thomas, Silvia M Frade Eguaras, Susan Gauthier, Dale L Phelps, Gary J Myers, Ronnie Guillet, Diane Hust, Linda J Reubens, Pablo J Sánchez, R Sue Broyles, Abbot R Laptook, Charles R Rosenfeld, Walid A Salhab, Roy J Heyne, Cathy Boatman, Cristin Dooley, Gaynelle Hensley, Jackie F Hickman, Melissa H Leps, Susie Madison, Nancy A Miller, Janet S Morgan, Lizette E Torres, Alicia Guzman, Jon E Tyson, Kathleen A Kennedy, Esther G Akpa, Claudia I Franco, Anna E Lis, Georgia E McDavid, Patti L Pierce Tate, Nora I Alaniz, Magda Cedillo, Susan Dieterich, Patricia W Evans, Charles Green, Margarita Jiminez, Terri Major-Kincade, Brenda H Morris, M Layne Poundstone, Stacey Reddoch, Saba Siddiki, Maegan C Simmons, Laura L Whitely, Sharon L Wright, Athina Pappas, Yvette R Johnson, Rebecca Bara, Laura A Goldston, Geraldine Muran, Deborah Kennedy, Patrick J Pruitt, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Elaine Romano, Joanne Williams, Susan DeLancy
Abstract
Objective: To evaluate the association between severity of cerebral palsy (CP) and growth to 6 to 7 years of age among children with moderate to severe (Mod/Sev) hypoxic ischemic encephalopathy (HIE). It was hypothesized that children with Mod/Sev CP would have poorer growth, lower cognitive scores, and increased rehospitalization rates compared with children with no CP (No CP).
Methods: Among 115 of 122 surviving children followed in the hypothermia trial for neonatal HIE, growth parameters and neurodevelopmental status at 18 to 22 months and 6 to 7 years were available. Group comparisons (Mod/Sev CP and No CP) with unadjusted and adjusted analyses for growth <10th percentile and z scores by using Fisher's exact tests and regression modeling were conducted.
Results: Children with Mod/Sev CP had high rates of slow growth and cognitive and motor impairment and rehospitalizations at 18 to 22 months and 6 to 7 years. At 6 to 7 years of age, children with Mod/Sev CP had increased rates of growth parameters <10th percentile compared with those with No CP (weight, 57% vs 3%; height, 70% vs 2%; and head circumference, 82% vs 13%; P < .0001). Increasing severity of slow growth was associated with increasing age (P < .04 for weight, P < .001 for length, and P < .0001 for head circumference). Gastrostomy feeds were associated with better growth.
Conclusions: Term children with HIE who develop Mod/Sev CP have high and increasing rates of growth <10th percentile by 6 to 7 years of age. These findings support the need for close medical and nutrition management of children with HIE who develop CP.
Trial registration: ClinicalTrials.gov NCT00005772.
Keywords: cerebral palsy; encephalopathy; growth; hypothermia; hypoxia-ischemia.
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Source: PubMed