Investigation Of Perinatal High Risk Factors In Children With Cerebral Palsy

Objective:To explore the risk factors of perinatal period in children with cerebral palsy,in order to provide the clinical basis for the prevention and treatment of cerebral palsy.Methods:From January 2006 to December 2016,1377 cases of children with cerebral palsy fist diagnosed in the pediatric center of ZhuJiang Hospital of Southern Medical University were selected as the study group,while the control group was selected with 1377 healthy children in the pediatric center during the same period.The survey was completed by reviewing the medical records and physical examination data.The survey included 21 antenatal factors:Premature birth,low birth weight,Miyamauchi Sako,multiple pregnancy,miscarriage,adverse pregnancy history,intrauterine infection,birth abnormalities,pregnancy induced hypertension,abnormal glucose tolerance during pregnancy,maternal age,maternal infections during pregnancy,trauma,placenta,placental abruption,premature rupture of membranes,umbilical cord around the neck,abnormal amniotic fluid volume,disease of family history,assisted reproductive technology and mothers with chronic diseases.7 intrapartum factors:Intrapartum asphyxia,meconium aspiration,amniotic fluid turbidity,prolonged labor,midwifery,aspiration pneumonia,and swallowing syndrome.12 postpartum factors:Postpartum asphyxia,neonatal pathological jaundice,auxiliary ventilation,intracranial hemorrhage,neonatal infection,unknown time HIE,encephalitis,neonatal convulsions,hydrocephalus,craniocerebral trauma,epilepsy and broad bean disease.The number of cases,gender,age,and various perinatal risk factors were recorded.Data analysis mainly was used composition ratio and Logistic regression analysis,P<0.05,the difference was statistically significant.Results:a total of 1377 children with cerebral palsy were collected in the study,260 cases were under 1 years,accounted for 18.9%;520 cases were more than 1 years old,less than 3 years,accounting for 37.8%;371 cases were more than 3 years old,less than 6 years,accounting for 26.9%;226 cases were more than 6 years old,accounting for 16.4%.Children were concentrated in the age of 1?6 years,accounting for 83.6%;Children under 3 years of age accounted for 56.6%.In the study,3777 numbers with cerebral palsy were collected,2230 prenatal factors,accounting for 59%,followed by 550 factors of birth time,accounting for 14.6%;997 postpartum factors,accounting for 26.4%.Compared with the normal control group,single factor Logistic regression analysis showed that 30 perinatal risk factors of preterm birth,birth asphyxia,premature rupture of membranes,abortion history,ventilation,adverse pregnancy,multiple pregnancy,unknown time HIE,intracranial hemorrhage,intrauterine infection,birth abnormalities,gestational hypertension,gestational impaired glucose tolerance,maternal age,maternal infection,umbilical cord around the neck meconium aspiration,amniotic fluid turbidity,prolonged labor,delivery,low birth weight,pneumonia and swallowing syndrome,Miyamauchi Sako,postpartum asphyxia,neonatal infection,neonatal seizures,family history,mother's history of chronic disease,hydrocephalus were related to cerebral palsy,P<0.05,the difference was statistically significant;Multivariate Logistic regression analysis was carried out on the basis of single factor,the resullts showed 20 perinatal risk factors of cerebral palsy was more important perinatal risk factors,P<0.05,the difference was statistically significant,and there were perinatal risk factors of cerebral palsy which were respectively the adverse pregnancy,gestational hypertension,abnormal glucose tolerance during pregnancy,maternal age,pregnancy infection and the umbilical cord around the neck,meconium aspiration,amniotic fluid turbidity,delivery,preterm delivery,aspiration pneumonia,swallowing syndrome,Miyamauchi Sako,birth asphyxia,postpartum asphyxia,unknown time HIE,neonatal infection,neonatal seizures,family history,mother's history of chronic disease.Conclusions:Prenatal high-risk factors,especially premature delivery and Pregnancy infection,were the most important risk factors for children with cerebral palsy;In addition to preterm birth,many other perinatal high-risk factors were significantly different from those in the control group,suggesting that the etiology of cerebral palsy is complicated,the focus of the prevention and treatment of cerebral palsy should be to strengthen the monitoring of pregnancy health care,monitor fetal development and improve obstetric techniques;There were more obvious gender differences in children with cerebral palsy than men.Among them,there were no obvious perinatal high-risk factors in 60 children with cerebral palsy,suggesting that genetic factors play a role in the pathogenesis of cerebral palsy,and further attention was deserved;Age of first visit for children with cerebral palsy was elder,more than 3 years old children accounted for 43.3%.It is suggested that we strengthen the knowledge of high-risk children propaganda and improve the understanding of parents is still a long way to go.