The role of intrauterine infections in the development of cerebral palsy in children

Maira Balgayeva, Sholpan A. Bulekbayeva, Zholtay R. Daribayev, A Takeneyeva, Aliya Seidullayeva

European Journal of Public Health, 2017

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DOI 10.1093/eurpub/ckx186.150
Data confidence 70 medium
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Abstract

Background To determine the main prognostic risk factors for cerebral palsy in intrauterine infection. Methods The study involved 27 children diagnosed with cerebral palsy, which has in anamnesis history of intrauterine infection. Was carried out the retrospective analysis of medical records of children, which diagnosed with cerebral palsy and their mothers to identify a causality and effect relationship between maternal infection and the severity of clinical disorders in children with cerebral palsy, as well as structural changes according to dates of neuroimaging. The structure by clinical forms: hemiplegic form - 7.4%, spastic diplegia - 48.1%, quadriplegia - 18.5%, atonic form - 14.8% and dyskinetic form - 11.1%. Results Among the clinical forms prevailed spastic form of cerebral palsy (74.1%). In the postnatal period in the examined children, the most frequently detected: inhibition of central nervous system syndrome (59.2%), change of muscle tone (96.2%). The peculiarity of the structural changes in the brain in infants with intrauterine infection according neurosonography were high incidence of periventricular leukomalacia (66.6%), cysts (29.6%), calcifications (40.7%) and signs of brain immaturity (48.1%). In the mothers of children surveyed in 57% of cases diagnosed burdened obstetric and gynecological history, 34.5% - chronical inflammatory gynecological diseases, 27.8% - extragenital pathology, in 24.2% of cases are diagnosed infections, which sexually transmitted diseases. Fetoplacental failure is found in 49% of cases (chronic - 64.3%, acute - 13.2% and combined - 22.5%). The leading risk factor for placental insufficiency is preeclampsia (p < 0.001). Conclusions Leading risk factors for cerebral palsy that have prognostic value are the number of conditions and diseases: signs of placental insufficiency, intrauterine growth retardation, intrauterine hypoxia, respiratory distress syndrome, convulsions, periventricular leukomalacia, cysts. Key messages: It is recommended the implementation of early diagnosis, detection and prevention system of intrauterine infection in all pregnant women. In the perinatal period all children with intrauterine infection included in the risk group for further depth neurological examination using neuroimaging techniques.