Cerebral Palsy After Neonatal Encephalopathy
Notice bibliographique
Résumé
In neonates with moderate or severe neonatal encephalopathy (NE), therapeutic hypothermia or “cooling” has been effective as a neuroprotective intervention in patients who meet eligibility criteria. There is hope that cooling might reduce the frequency of cerebral palsy (CP) in neonates with NE born at full term. However, there is no strategy for neuroprotection of neonates born at term with NE who do not meet eligibility criteria for therapeutic hypothermia. This study aimed to gauge the proportion of CP cases after NE that could be prevented with hypothermia treatment and to also explain the perinatal factors associated with CP after NE in patients who do not meet criteria for cooling. This study used data from the Canadian Cerebral Palsy Registry, which included children at least 2 years old who met current criteria for CP. Criteria for hypothermia treatment eligibility came from the Position Statement of the Canadian Paediatric Society and the National Institute of Child Health and Human Development randomized controlled trial of therapeutic hypothermia. To investigate variables that might separate infants who meet cooling criteria from those who do not, a series of factors (maternal, paternal, postnatal, and placental) were compared. Previous meta-analysis of randomized controlled trials found the number needed to treat to prevent 1 case of CP was 8, which was therefore used in this analysis. Of the 1001 patients enrolled in the Canadian Cerebral Palsy Registry between 1999 and 2011, 155 were 36 weeks’ gestation or greater, with a birth weight of 1800 g or greater and had moderate or severe NE. Of this cohort, 64 (41%) met cooling criteria, and 91 (59%) did not. Thirteen neonates were actually cooled: 11 who met cooling criteria (17%) and 2 who did not (2%). All 13 neonates who were cooled were born in or after 2009. In the cohort, children who met cooling criteria were more likely to have hypotonia than children who did not (P = 0.02). Between the 2 groups, there were no significant differences in antenatal maternal or paternal variables. In the group that met cooling criteria, signs of perinatal distress, including cesarean delivery, low pH, low Apgar score, or resuscitation at birth, were significantly more common (P < 0.0001). In the group that did not meet cooling criteria, shoulder dystocia was more common than in those who did meet the criteria (odds ratio, 8.8; 95% confidence interval, 1.1–71.4). Hypothermia could prevent term CP after NE in an estimated 5.1% of cases (95% confidence interval, 2.4%–6.9%). To reduce the burden of CP, it is imperative to have a better understanding of the antenatal processes underlying NE.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».