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Cerebral palsy is a term that includes a group of conditions that affect people's ability to move; it is the most common type of physical disability in childhood. Cerebral palsy is usually caused by events before, during, or after childbirth that damage the developing brain of the baby. No single cause of cerebral palsy is known. For many children, the cause of cerebral palsy remains unclear, but many risk factors are known. The most important risk factor is preterm birth (birth before 37 weeks of gestation). Other risk factors during the neonatal period (from birth to one month of life) include prolonged lack of oxygen during labor; brain damage; strokes or seizures; disorders of the heart, blood vessels, respiratory tract and lungs. Long-term mechanical assistance to maintain breathing (artificial ventilation of the lungs); some infections; jaundice (yellow discoloration of the skin and eyes due to excess bilirubin in the blood); and some syndromes or abnormalities of chromosomes (structures that hold genes) are all risk factors.
Since there are different risk factors and cau Babies & Kids goods in Nigeria ses of cerebral palsy, it is likely that different interventions may be needed to prevent cerebral palsy by reducing the risk factors. This review summarizes the evidence for the prevention of cerebral palsy that has been presented in the Cochrane Systematic Reviews of Neonatal Interventions.
What evidence have we found?
We searched for evidence on November 27, 2016, and identified 43 Cochrane reviews evaluating neonatal interventions that reported some information on cerebral palsy. All of these reviews were of medium to high quality, but the quality of the evidence for cerebral palsy ranged from very low to high. Three reviews evaluated interventions for newborns who may experience oxygen deprivation during labor; 33 reviews evaluated interventions for premature or low birth weight infants; and seven reviews evaluated interventions for other groups of newborns who were at risk for brain damage (eg, newborns with low blood sugar at birth).
We found that one intervention was effective in preventing cerebral palsy. Newborn infants who may have had oxygen deprivation at birth and who had induced hypothermia (cooling of the body or brain alone) were less likely to develop cerebral palsy than infants who did not receive hypothermia (seven trials; 881 infants; high evidence quality). We found that one intervention may have been effective in preventing cerebral palsy. Preterm infants who received methylxanthines (caffeine) while planning to wean (during extubation) were less likely to develop cerebral palsy than infants who received placebo (one trial; 644 infants; moderate-quality evidence). We found one intervention that is likely to be ineffective and potentially harmful: Premature infants who received early (less than eight days of age) corticosteroids to prevent chronic lung disease were more likely to develop cerebral palsy than infants who received placebo (12 trials ; 959 children; moderate quality evidence). We found that five other interventions were likely ineffective (did not prevent or increase the likelihood of cerebral palsy) (moderate quality evidence). The review authors did not find sufficient evidence to say if other interventions were prevented, increased
or had no effect on cerebral palsy (low or very low quality evidence).
This review identified one intervention that was effective in preventing cerebral palsy (induced hypothermia for newborns who may have had a lack of oxygen); one intervention that was possibly effective in preventing cerebral palsy (caffeine for premature babies during weaning); and one that appears to be harmful (corticosteroids under eight days of age in premature infants for the prevention of chronic lung disease); and five interventions that did not appear to have an effect. For the other assessed interventions, there was insufficient evidence to draw conclusions. It is important that additional good quality trials evaluating interventions that might affect risk factors for cerebral palsy conduct long-term observations to measure the impact of these interventions. We have identified over 100 other Cochrane Reviews that may provide information on neonatal interventions for the prevention of cerebral palsy in the future, if they include long-term follow-up.
Translation: Yudina Ekaterina Viktorovna. Editing: Ziganshina Lilia Evgenievna. Project coordination for translation into Russian: Cochrane Russia - Coc
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