The Experts below are selected from a list of 58554 Experts worldwide ranked by ideXlab platform
Dwight J Rouse - One of the best experts on this subject based on the ideXlab platform.
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evaluation of the clinical use of magnesium sulfate for Cerebral Palsy prevention
Obstetrics & Gynecology, 2013Co-Authors: Karen J Gibbins, Karen R Browning, Vrishali Lopes, Brenna L Anderson, Dwight J RouseAbstract:OBJECTIVE:Clinical trials support the efficacy and safety of magnesium sulfate for Cerebral Palsy prevention. We evaluated the implementation of a clinical protocol for the use of magnesium for Cerebral Palsy prevention in our large women's hospital, focusing on uptake, indications, and safety.METHO
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magnesium sulfate for the prevention of Cerebral Palsy
American Journal of Obstetrics and Gynecology, 2009Co-Authors: Dwight J RouseAbstract:Three large, randomized placebo-controlled trials of antenatal magnesium sulfate (MgSO 4 ) for fetal neuroprotection have recently been conducted and reported. The results of these trials provide strong support for the utilization of MgSO 4 to lower the risk of Cerebral Palsy among the survivors of early preterm birth. In the United States, the use of MgSO 4 for fetal neuroprotection has the potential to prevent 1000 cases of handicapping Cerebral Palsy annually.
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a randomized controlled trial of magnesium sulfate for the prevention of Cerebral Palsy
Obstetrical & Gynecological Survey, 2009Co-Authors: Dwight J Rouse, Deborah Hirtz, Elizabeth Thom, Michael W Varner, Catherine Y Spong, Brian M Mercer, Jay D Iams, Ronald J Wapner, Yoram Sorokin, James M AlexanderAbstract:Early preterm birth is associated with approximately one third of all cases of Cerebral Palsy and is a risk factor. A case-control study was the first to show a decrease in the incidence of Cerebral Palsy in the offspring of women who were given magnesium sulfate before preterm delivery. This randomized, placebo-controlled, double-blind trial tested the hypothesis that antenatal administration of magnesium sulfate would reduce the incidence of Cerebral Palsy in the children of women at high risk for early preterm delivery. At 20 sites across the United States from December 1997 through May 2004,2241 women at high risk for spontaneous delivery at 24 through 31 weeks' gestation were randomized to receive either intravenous magnesium sulfate (6 gm infusion for 20 to 30 minutes followed by a maintenance infusion of 2 gm per hour) or a placebo. The primary outcome was the composite of stillbirth or infant death by 1 year of age or moderate or severe Cerebral Palsy at or beyond 2 years of age. A trained psychologist or psychometrist administered and assessed scores on the Bayley Scales of Infant Development II. Baseline characteristics of the two groups were matched. Over 95% of the children were followed for 24 months. Corrections were made for prematurity. No significant differences were found for the primary composite outcome of moderate or severe Cerebral Palsy or death in the offspring of the magnesium sulfate group and the placebo group (11.3 versus 11.7%; relative risk, 0.97; 95% confidence interval [CI], 0.77 to 1.23; P = .80). However, women in the magnesium sulfate group had a significantly lower risk of giving birth to an infant who subsequently developed moderate or severe Cerebral Palsy than women in the placebo group (1.9% versus 3.5%, respectively; relative risk, 0.55; 95% CI, 0.32 to 0.95; P ≤.03). There was no difference in scores on the Bayley scales of infant development between the two groups. No life threatening maternal events were noted in either group. This study is consistent with previous reports that antenatal magnesium sulfate does not reduce the combined risk of death or moderate or severe Cerebral Palsy, but may reduce the risk of Cerebral Palsy among survivors.
Ann Johnson - One of the best experts on this subject based on the ideXlab platform.
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Cerebral Palsy and intrauterine growth in single births european collaborative study
The Lancet, 2003Co-Authors: S N Jarvis, Ann Johnson, Svetlana V Glinianaia, Mariagiulia Torrioli, Mary Jane Platt, Maria Miceli, Pierresimon Jouk, Jane L Hutton, Karla Hemming, Gudrun HagbergAbstract:BACKGROUND: Cerebral Palsy seems to be more common in term babies whose birthweight is low for their gestational age at delivery, but past analyses have been hampered by small datasets and Z-score calculation methods. METHODS: We compared data from ten European registers for 4503 singleton children with Cerebral Palsy born between 1976 and 1990 with the number of births in each study population. Weight and gestation of these children were compared with reference standards for the normal spread of gestation and weight-for-gestational age at birth. FINDINGS: Babies of 32-42 weeks' gestation with a birthweight for gestational age below the 10th percentile (using fetal growth standards) were 4-6 times more likely to have Cerebral Palsy than were children in a reference band between the 25th and 75th percentiles. In children with a weight above the 97th percentile, the increased risk was smaller (from 1.6 to 3.1), but still significant. Those with a birthweight about 1 SD above average always had the lowest risk of Cerebral Palsy. A similar pattern was seen in those with unilateral or bilateral spasticity, as in those with a dyskinetic or ataxic disability. In babies of less than 32 weeks' gestation, the relation between weight and risk was less clear. INTERPRETATION: The risk of Cerebral Palsy, like the risk of perinatal death, is lowest in babies who are of above average weight-for-gestation at birth, but risk rises when weight is well above normal as well as when it is well below normal. Whether deviant growth is the cause or a consequence of the disability remains to be determined.
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Cerebral Palsy and clinical negligence litigation a cohort study
Journal of Obstetrics and Gynaecology, 2003Co-Authors: Catherine Greenwood, Sally Newman, Lawrence Impey, Ann JohnsonAbstract:We set out to compare the characteristics of children with Cerebral Palsy who have and have not been the subjects of clinical negligence legal claims. This involved a nested cohort study within a geographically defined cohort of a former Health Authority. Participants were singleton children with Cerebral Palsy born between 1984 and 1993, excluding cases with a recognised postnatal cause for Cerebral Palsy. The main outcome measures were the three ‘essential’ criteria defined by the International Cerebral Palsy Task Force which identify acute intrapartum hypoxia. One-fifth (27/138) of all singleton CP children were the subject of a legal claim. The presence of all three criteria was significantly more likely to lead to a legal claim (P < 0.01), but in 74% (20/27) of claims all three were not fulfilled and 36% (4/11) of those satisfying all three criteria did not claim. At least one of the three criteria was met in 82% (91/111) of the cases where there was no claim. Data on fetal or neonatal arterial blood...
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Cerebral Palsy and clinical negligence litigation a cohort study
British Journal of Obstetrics and Gynaecology, 2003Co-Authors: Sally Newman, Catherine Greenwood, Lawrence Impey, Ann JohnsonAbstract:Objective To compare the prevalence of criteria suggesting acute intrapartum hypoxia in children with Cerebral Palsy who have and have not been the subjects of clinical negligence legal claims. Design Nested cohort study within a geographically defined cohort. Setting The former Oxfordshire Health Authority. Population Singleton children with Cerebral Palsy born between 1984 and 1993, excluding cases with a recognised postnatal cause for Cerebral Palsy. Methods Retrospective review of medical records by blinded observer. Main outcome measures Three ‘essential’ criteria defined by the International Cerebral Palsy Task Force which identify acute intrapartum hypoxia. Results One-fifth (27/138) of all singleton Cerebral Palsy children were the subject of a legal claim. The presence of all three criteria was significantly more likely to lead to a legal claim (P < 0.01), but in 74% (20/27) of claims, all three were not fulfilled and 36% (4/11) of those satisfying all three criteria did not claim. At least one of the three criteria was met in 82% (91/111) of the cases where there was no claim. Data on fetal or neonatal arterial blood gases were available in only 57% (78/138). Of the 27 claims, 12 were discontinued, 8 were settled and in 7 the legal process is still pending. The presence of the three essential criteria for acute intrapartum hypoxia did not increase the likelihood of a legal claim being settled. Conclusion The prevalence of the ‘template essential’ criteria is high in all cases of Cerebral Palsy. Although the presence of all three essential criteria was more likely in the claims group, this did not appear to influence the outcome of a claim. It remains to be seen whether the existence of the template leads to change in the pattern of decisions made by the courts.
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case control study of antenatal and intrapartum risk factors for Cerebral Palsy in very preterm singleton babies
The Lancet, 1995Co-Authors: Deirdre J Murphy, Ann Johnson, S Sellers, I Z MackenzieAbstract:Abstract Summary The increase in survival of very preterm babies during the 1980s was accompanied by a sharp increase in the rate of Cerebral Palsy in this group. The relation between antenatal and intrapartum factors and Cerebral Palsy in such babies has not been well defined. To identify adverse and protective antenatal and intrapartum factors we undertook a case-control study of 59 very preterm babies who developed Cerebral Palsy, identified from a population-based register, and 234 randomly selected controls. The frequency of Cerebral Palsy decreased with increasing gestational age and birthweight. Antenatal complications occurred in 215 (73%) of the women with preterm deliveries. Factors associated with an increased risk of Cerebral Palsy after adjustment for gestational age were chorioamnionitis (odds ratio 4·2 [95% Cl 1·4-12·0]) prolonged rupture of membranes (2·3 [1·2-4·2]), and maternal infection (2·3 [1·2-4·5]). Pre-eclampsia was associated with a reduced risk of Cerebral Palsy (0·4 [0·2-0·9]), as was delivery without labour (0·3 [0·2-0·7]). There was no increased risk of Cerebral Palsy with intrauterine growth retardation (1·0 [0·9-1·1]). The effect of rigorous management of adverse antenatal factors on the frequency of Cerebral Palsy in very preterm babies should be tested in randomised controlled trials.
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Case-control study of intrapartum care, Cerebral Palsy, and perinatal death.
BMJ (Clinical research ed.), 1994Co-Authors: G Gaffney, Susan Sellers, V Flavell, Marian V Squier, Ann JohnsonAbstract:Abstract Objective: To investigate the relation between suboptimal intrapartum obstetric care and Cerebral Palsy or death. Design: Case-control study. Setting: Oxford Regional Health Authority. Subjects - 141 babies who subsequently developed Cerebral Palsy and 62 who died intrapartum or neonatally, 1984-7. All subjects were born at term of singleton pregnancies and had no congenital anomaly. Two controls, matched for place and time of birth, were selected for each index case. Main outcome measures - Adverse antenatal factors and suboptimal intrapartum care (by using predefined criteria). Results: Failure to respond to signs of severe fetal distress was more common in cases of Cerebral Palsy (odds ratio 4.5; 95% confidence interval 2.4 to 8.4) and in cases of death (26.1; 6.2 to 109.7) than among controls. This association persisted even after adjustment for increased incidence of a complicated obstetric history in cases of Cerebral Palsy. Neonatal encephalopathy is regarded as the best clinical indicator of birth asphyxia; only two thirds (23/33) of the children with Cerebral Palsy in whom there had been a suboptimal response to fetal distress, however, had evidence of neonatal encephalopathy; these 23 formed 6.8% of all children with Cerebral Palsy born to residents of the region in the four years studied. Conclusion: There is an association between quality of intrapartum care and death. The findings also suggest an association between suboptimal care and Cerebral Palsy, but this seems to have a role in only a small proportion of all cases of Cerebral Palsy. The contribution of adverse antenatal factors in the origin of Cerebral Palsy needs further study.
Isabelle Bouchart - One of the best experts on this subject based on the ideXlab platform.
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mental imagery abilities in adolescents with spastic diplegic Cerebral Palsy
Journal of Intellectual & Developmental Disability, 2004Co-Authors: Yanick Courbois, Yann Coello, Isabelle BouchartAbstract:Four visual imagery tasks were presented to three groups of adolescents with or without spastic diplegic Cerebral Palsy. The first group was composed of six adolescents with Cerebral Palsy who had ...
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Mental imagery abilities in adolescents with spastic diplegic Cerebral Palsy
Journal of Intellectual and Developmental Disability, 2004Co-Authors: Yanick Courbois, Yann Coello, Isabelle BouchartAbstract:Four visual imagery tasks were presented to three groups of adolescents with or without spastic diplegic Cerebral Palsy. The first group was composed of six adolescents with Cerebral Palsy who had associated visual-perceptual deficits (CP-PD), the second group was composed of five adolescents with Cerebral Palsy and no associated visual-perceptual deficits (CP), and the third group comprised ten control participants. Results revealed a marked slowdown of visual imagery processing in the CP-PD group only. They suggested that Cerebral Palsy is not systematically associated with visual imagery deficits, and that the presence or absence of such deficits depends on the existence of associated perceptual deficits.
Sarah Mcintyre - One of the best experts on this subject based on the ideXlab platform.
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neonatal interventions for preventing Cerebral Palsy an overview of cochrane systematic reviews
Cochrane Database of Systematic Reviews, 2016Co-Authors: Emily Shepherd, Sarah Mcintyre, Nadia Badawi, Rehana A Salam, Philippa Middleton, Shanshan Han, Maria Makrides, Caroline A CrowtherAbstract:This is a protocol for a Cochrane Review (Overview). The objectives are as follows: The primary objective of this overview is to summarise the evidence from Cochrane systematic reviews regarding the effects of neonatal interventions for preventing Cerebral Palsy (reducing Cerebral Palsy risk). A secondary objective of this overview is to summarise any evidence identified from Cochrane systematic reviews regarding the effects of neonatal interventions that increase Cerebral Palsy.
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antecedents of Cerebral Palsy and perinatal death in term and late preterm singletons
Obstetrics & Gynecology, 2013Co-Authors: Sarah Mcintyre, Eve Blair, Nadia Badawi, John M Keogh, Karin B NelsonAbstract:Objective To examine the antecedents of Cerebral Palsy and of perinatal death in singletons born at or after 35 weeks of gestation. Methods From a total population of singletons born at or after 35 weeks of gestation, we identified 494 with Cerebral Palsy and 508 neonates in a matched control group, 100 neonatal deaths, and 73 intrapartum stillbirths (all deaths in selected birth years). Neonatal death and Cerebral Palsy were categorized as without encephalopathy, after neonatal encephalopathy, or after neonatal encephalopathy considered hypoxic-ischemic. We examined the contribution of potentially asphyxial birth events, inflammation, fetal growth restriction, and birth defects recognized by age 6 years to each of these outcomes and to intrapartum stillbirths. Results The odds of total Cerebral Palsy after potentially asphyxial birth events or inflammation were modestly increased (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.1-3.2 and OR 2.2, 95% CI 1.0-4.2, respectively). However, potentially asphyxial birth events occurred in 34% of intrapartum stillbirths and 21.6% of Cerebral Palsy after hypoxic-ischemic encephalopathy. Inflammatory markers occurred in 13.9% and 11.9% of these outcomes, respectively. Growth restriction contributed significantly to all poor outcome groups. Birth defects were recognized in 5.5% of neonates in the control group compared with 60% of neonatal deaths and more than half of cases of Cerebral Palsy without hypoxic-ischemic encephalopathy. In children with Cerebral Palsy, a potentially asphyxial birth event, inflammation, or both were experienced by 12.6%, whereas growth restriction, a birth defect, or both were experienced by 48.6% (P Conclusion Fetal growth restriction and birth defects recognized by age 6 years were more substantial contributors to Cerebral Palsy and neonatal death than potentially asphyxial birth events and inflammation. Level of evidence : II.
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chorioamnionitis and Cerebral Palsy a meta analysis
Obstetric Anesthesia Digest, 2011Co-Authors: Jobe G Shatrov, Sarah Mcintyre, Samuel C M Birch, Lawrence T Lam, Julie A Quinlivan, George L MendzAbstract:OBJECTIVE:To examine the relationships between clinical or histological chorioamnionitis and Cerebral Palsy using a meta-analysis approach.DATA SOURCES:A systematic review of the literature appeared in PubMed between 2000 and 2009 was conducted using the search terms “Cerebral Palsy” and “infection,
T Cooke - One of the best experts on this subject based on the ideXlab platform.
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Cerebral Palsy and multiple births.
Archives of disease in childhood. Fetal and neonatal edition, 1996Co-Authors: Peter O. D. Pharoah, T CookeAbstract:AIM: To compare the birthweight specific prevalence of Cerebral Palsy in singleton and multiple births. METHODS: Registered births of babies with Cerebral Palsy born to mothers resident in the counties of Merseyside and Cheshire during the period 1982 to 1989 were ascertained. RESULTS: The crude prevalence of Cerebral Palsy was 2.3 per 1000 infant survivors in singletons, 12.6 in twins, and 44.8 in triplets. The prevalence of Cerebral Palsy rose with decreasing birthweight. The birthweight specific prevalence among those of low birthweight or = 2500 g, there was a significantly higher risk in multiple than in singleton births. The higher crude Cerebral Palsy prevalence in multiple births is partly due to the lower birthweight distribution and partly due to the higher risk among normal birthweight infants. CONCLUSIONS: Multiple birth babies are at increased risk of Cerebral Palsy. There is also an increased risk of Cerebral Palsy within a twin pregnancy if the co-twin has died in utero.
