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CEREBRAL PALSY:INVESTIGATION OF IT'S CAUSAL FACTORS AND GENETICAL BACKGROUND Hideaki Kudo 1 , Masataka Arima 1 , Nobu Tanase 2 , Yasuyuki Suzuki 2 , Shigehiro Oka 2 , Hiroyuki Choh 2 1Devision of Mental Retardation and Birth Defect Research, National Center for Nervous, Mental and Muscular Disorders 2Tokyo Infant Rehabilitation Hospital pp.1043-1051
Published Date 1985/11/1
DOI https://doi.org/10.11477/mf.1406205605
  • Abstract
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In the last 30 years the prevalence rate of cere-bral palsy (CP) has remarkably decreased in Japan. The decrease is arbitrarily attributed to the re-duced frequency of such risk factors for CP, as low birthweight, severe asphyxia, and kernicterus in the neonatal period. However, there is no sta-tistical data providing the evidence that CP pa-tients complicating these risk factors have actually decreased so far. In order to make clear the bases of the decrease in prevalence of CP, we examined the changing patterns in the suggested cause of CP, experienced in the last 30 years. The investigation included the maternal condition of pregnancy and delivery, in relation to the neonatal risk factors, and genetic background of the family. In CP, low birthweight babies of 2500 gm or less were common (36.9%) and the meanbirthweight (2689 gm) was obviously smaller than that of general population. In spite of the constant decline of the incidence of low birthweight babies in the general populationin in the last 30 years, the ratio of low birthweight to total births in CP group had not changed in this study period. It was concluded that the low birthweight follow-ing premature birth is still an important predis-posing factor of CP. Asphyxia was frequently seen in the CP population. The rate of asphyxia was significantly higher in the group with a nor-mal birthweight more than 2501 gm (58.4%), or gestational weeks longer than 36 weeks (57.7%), comparing with that of low birthweight (41.1%), or premature (40.7%) group. In the last 14 years,the rate of asphyxia was apparently reduced in the group with normal birthweight (before 1969; 65.6%, after 1970; 44.6%) or gestational weeks longer than 36 weeks (before 1969; 65.8%, after 1970; 43.5%), while it was unchanged in the low birthweight or premature group. When the de-livery was abnormal, asphyxia increased in the mature group. The condition of of delivery less influenced the frequency of asphyxia in the premature. The frequency of jaundice of moderate or severe degree was high in low birthweigh group, and the incidence was not so changed in the study period. It decreased slightly in the group with birthweight more than 2501 gm (before 1969; 35.7%, after 1970; 24.8%). Jaundice of se-vere degree, possibly associated with kernicterus, decreased significantly after 1966. The rate of consanguinity of parents of CP was 4.8%. The rate tended to be high in the group with less risk factors. It was 17.6%, in the group with birthweight more than 2501 gm, normal pregnancy and delivery, and with neither asphyxia nor jaun-dice. Sib risk was 2.4%. The risk also tended to be high in the group without any risk factors, and any troubles during pregnancy and delivery (15.8%). The family history about neuro-psycho-muscular diseases, including sib patients, was seen in 6.4% of families with CP. In conclusion, the frequency of some risk factors in the CP grouphad been gradually changed in the last 30 years, but no risk factors had actually increased. These result suggest the possibility that the CP with less risk factors will increase in the future. In our study the number of these CP was too small for precise analysis of genetical factors in CP. However, several tendencies, seen in the study of sib risk, consanguinity, or family history about neuro-psycho-muscular diseases, suggest that ge-netical factors might take part in CP.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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