Cerebral Palsy in Very Preterm Infants: A Nine-Year Prospective Study in a French Population-Based Tertiary Center - 22/09/21

Doi : 10.1016/j.jpeds.2021.06.018

Clément Chollat, MD, PhD ^1,^2,^{^{†
Contributed equally.}}, Emmanuelle Bertrand, MD ^1,^3,^{^{†
Contributed equally.}}, Alice Petit-Ledo, MD ³, Caroline de Vansay, MD ⁴, Caroline Voisin, MD ³, Ivana Dabaj, MD ^1,³, André Gillibert, MD, PhD ⁵, Stéphane Marret, MD, PhD ^1,^3,^⁎
for the
Perinatal Network of Upper Normandy^∗
A list of additional members of the Perinatal Network of Upper Normandy is available at www.jpeds.com (Appendix 1).
C. Lévêque, J.-L. Simenel, MD, S. Pauthier, MD, C. Levavasseur, MD, I. Pop, MD, N. Grancher, MD, A. Lefebure, MD, C. Vittecoq, MD, D. Dabbagh, MD, E. Machevin, MD, M. Levy, MD, F. Taleb, MD, H. Lahrach, MD, H. Rhali, MD, B. Richet, MD, F. Delaunay, MD, H. Bruel, MD, A. Selim, MD, M. Jaffray, MD, M. Durand-Réville, MD, C. Sarreau, MD, S. Celik, MD, J.-F. Le Digabel, MD, J. Stoller, MD, H. Muszynski, MD, M. Rouha, MD, E. Verspyck, MD, PhD, A. Chadi, MD, C. Lardennois, MD

¹ INSERM U1245, Genetics and Pathophysiology of Neurodevelopmental Disorders Team, Institute of Research and Innovation in Biomedicine, Faculty of Medicine, Normandy University, Caen, France
² Neonatal Intensive Care Unit, Port-Royal, Paris Center University Hospitals, APHP, Paris Descartes University, Paris, France
³ Department of Neonatal Pediatrics and Intensive Care–Neuropediatrics, CHU Rouen, Rouen, France
⁴ Neonatal Intensive Care Unit, Le Havre Hospital, Le Havre, France
⁵ Department of Biostatistics, CHU Rouen, Rouen, France

^∗Corresponding author: Stéphane Marret, MD, PhD, Department of Neonatal Pediatrics and Intensive Care–Neuropediatrics, CHU Rouen, 1 rue de Germont, 76000 Rouen, France.Department of Neonatal Pediatrics and Intensive Care–NeuropediatricsCHU Rouen1 rue de GermontRouen76000France

Abstract

Objectives

To describe the prevalence of cerebral palsy (CP) at age 2 years in infants born before 33 weeks of gestation and to analyze the fetal neuroprotective effect of the antenatal administration of magnesium sulfate (MgSO₄) treatment on CP.

Study design

Preterm infants born before 33 weeks of gestation and discharged from the Rouen University Hospital's Neonatal Intensive Care Unit between 2007 and 2015 were included. At age 2 years, pediatricians of the perinatal network of Eure and Seine-Maritime counties administered standardized questionnaires analyzing motor, cognitive, and behavioral items, derived from the Denver and Amiel-Tison scales. A routine protocol based on MgSO₄ infusion was introduced in 2010. The primary outcome measure was the occurrence of CP according to the Surveillance of Cerebral Palsy in Europe network definition.

Results

A total of 1759 very preterm infants were included, among whom 138 (7.8%) died and 148 (9.1%) were lost to follow-up. Assuming that those lost to follow-up had no CP, at 2 years, 55 of 1621 infants (3.4%; 95% CI, 2.6%-4.4%) had CP. After statistical adjustment for birth term and antenatal corticosteroid use, a significant decrease in CP was observed after implementation of a protocol of MgSO₄ administration in mothers before imminent preterm birth at <33 weeks of gestation (aOR, 0.53; 95% CI, 0.29-0.98; P = .04).

Conclusions

The prevalence of CP at 2 years after very preterm birth was low. The implementation of a neuroprotective protocol with MgSO₄ was associated with reduced CP occurrence; however, several relevant limitations must be considered for interpretation.

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Keywords : neurodevelopment, very preterm, death, cognitive functioning, corticosteroids, magnesium sulfate

Abbreviations : CP, cUS, EPIPAGE, MgSO₄, NICU, PVL, SCPE

Plan

MgSO₄ Antenatal Treatment

Discussion

Data statement

The authors declare no conflicts of interest.

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Vol 237

P. 183 - octobre 2021 Retour au numéro

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Cerebral Palsy in Very Preterm Infants: A Nine-Year Prospective Study in a French Population-Based Tertiary Center - 22/09/21

Abstract

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Plan

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