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CEREBRAL PALSY ARTICLES
NEW
YORK (Reuters Health) - Possible methods of preventing cerebral palsy in
full-term and premature infants are suggested by two new studies reported in
this week's Journal of the American Medical Association.
Cerebral palsy is a group of chronic disorders that appear in the first few
years of life. All of the disorders involve impaired body movement and stem from
damage to the brain.
For
full-term infants, preventing chorioamnionitis, an infection of the membrane
enclosing the fetus, or countering its effects may help prevent cerebral palsy,
according to the first report. When a preterm infant is expected, treating the
mother with a drug called magnesium sulfate before delivery may reduce the risk
of cerebral palsy, the second report suggests.
About
half of all cerebral palsy cases involve full- or near-term infants. Although
risk factors for cerebral palsy in such infants are unclear, recent reports have
suggested an association with chorioamnionitis.
To
investigate, Dr. Yvonne W. Wu, from the University of California at San
Francisco, and colleagues conducted a study of more than 230,000 infants who
were full- or near-term at birth. The study compared the 109 infants identified
with cerebral palsy with 218 infants randomly chosen from the study population.
Chorioamnionitis was diagnosed in 14 percent of kids with cerebral palsy, but in
only 4 percent of other children. Moreover, on further analysis, this pregnancy
problem was a strong predictor of cerebral palsy, associated with a fourfold
increased risk. The authors estimate that about 11 percent of cerebral palsy
cases were related to chorioamnionitis.
In the
second study, Dr. Caroline A. Crowther, from The University of Adelaide in
Australia, and colleagues looked at the ability of prenatal magnesium sulfate to
reduce the risk of cerebral palsy or death in preterm infants. Previous studies
have yielded conflicting results regarding the benefits of such therapy, but,
until now, no large trials have tested magnesium sulfate given solely to protect
the infant's brain.
The
study involved a total of 1062 pregnant women, at risk for preterm delivery, who
were treated with intravenous magnesium sulfate or saline before delivery. In
all cases, delivery was planned or expected within the next 24 hours.
Infants in the magnesium sulfate group were slightly less likely to die or have
cerebral palsy than infants in the control group. However, magnesium sulfate did
seem to offer substantial protection against serious movement problems.
"These
two important studies as well as other studies provide hope that the risk of
cerebral palsy can be reduced among both preterm and term infants," Dr. Jon E.
Tyson and Dr. Larry C. Gilstrap, from the University of Texas Medical School in
Houston, note in a related editorial.
"Performance of well-designed research to prevent this often devastating
condition deserves highest priority," they add.
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