Article

European Journal of Pediatrics

, Volume 123, Issue 2, pp 67-81

Analysis of etiologic factors in cerebral palsy with severe mental retardation

I. analysis of gestational, parturitional and neonatal data
  • M. V. DurkinAffiliated withThe Wisconsin Clinical Genetics Center of the Department of Medical Genetics
  • , E. G. KaveggiaAffiliated withThe Department of Pediatrics of the Center for Health Sciences and Medical SchoolCentral Wisconsin Colony and Training School
  • , E. PendletonAffiliated withCentral Wisconsin Colony and Training School
  • , G. NeuhäuserAffiliated withThe Wisconsin Clinical Genetics Center of the Department of Medical GeneticsThe Department of Pediatrics of the Center for Health Sciences and Medical SchoolThe Harry A. Waisman Center on Mental Retardation and Human Development of the University of Wisconsin
  • , J. M. OpitzAffiliated withThe Wisconsin Clinical Genetics Center of the Department of Medical GeneticsThe Department of Pediatrics of the Center for Health Sciences and Medical School

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Abstract

We analyzed the gestational, parturitional, neonatal (GPN) histories of 281 severely mentally retarded patients with cerebral palsy to define the etiology or pathogenesis of cerebral palsy in each patient. No association between type of cerebral palsy and GPN histories was found except for an increase in spastic-athetoid patients in the breech delivery subgroup. Significant findings include: increased incidence of prematurity and postmaturity, small and large for-gestational age (GA) fetal size, a normal birthweight for GA distribution of patients with diabetic mothers, an excess of mothers ≥35 and ≤20 years old, an increased immediately-previous sib interval of 2.59 years suggestive of an “infertility factor”, an unremarkable GPN history in one third of the cases, in another one third GPN problems not usually associated with a high risk of CNS damage, and in one third gross complications which were probably responsible for the CP, including: an increased incidence of breech deliveries, twinning, prolonged and precipitous labor and placental complications; no increased association of athetosis and Rh incompatibility or incidence of toxemia was found. Disseminated intravascular coagulation due to prenatal death of a twin may have been the cause of brain damage in several patients.

Key words

Birth history Cerebral palsy Etiology Twinning Spastic tetraplegia Gestation length Birthweight