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Advanced Neurology Neonatal encephalopathy and cerebral palsy

NE and overestimation in patients without NE, potentially distinctions between male and female CP patients with a
explaining our finding of a smaller portion of CP patients history of NE, further investigations are imperative.
with a history of NE. It is crucial to recognize that, beyond The present analysis identified a subset of CP patients
NE, numerous preconceptional, prenatal, perinatal, and with a history of NE. Notably, this subset, though smaller
postnatal factors contribute to CP development . in comparison to the total CP patient population, manifests
[9]
While our study primarily focused on establishing the a heightened incidence of severe complications. This
independent correlation between NE to CP, it is equally observation is consistent with prior research indicating
important to investigate the cumulative causes contributing that children who were encephalopathic and subsequently
to CP development. Perinatal pathology resulting in brain developed CP faced a more unfavorable prognosis than
injury, such as birth asphyxia [9,48] , plays a pivotal role in their non-encephalopathic CP counterparts . A recent
[33]
CP development, accounting for approximately 30.5% meta-analysis focusing on neurodevelopmental outcomes
of reported CP cases; prenatal factors also contribute in pre-term infants following intraventricular hemorrhage
significantly, representing 21% of CP cases (Figure 1). and white matter injury has highlighted a significantly
[10]
Prematurity and being underweight are considered the increased crude risk of moderate to severe CP, as well as
most significant contributing prenatal risk factors for visual, hearing, and cognitive impairment . Within the
[54]
CP [9,48] . A previous study using a database encompassing scope of our analysis, 5 of the 6 common complications
over 6000 children with CP demonstrated that CP associated with CP exhibited a positive correlation with
incidences were 70 times higher among premature infants a history of NE, and notably, 3 of these correlations
weighing less than 1500 grams at birth compared to those reached statistical significance. The discerned pattern of
with a birth weight exceeding 2500 g . Furthermore, complications in individuals with a history of NE provides
[49]
research has revealed that the incidence of CP increased to valuable insights that can inform and guide future efforts
146 cases/1000 live births in premature infants born before aimed at preventing and mitigating CP-related impairments
the 28 week of pregnancy . Moreover, recent genetic through early intervention in infants following NE.
[50]
th
studies have provided novel insights into CP etiology, CP is commonly diagnosed between the ages of
identifying cases devoid of prenatal, natal, or postnatal 12 – 24 months; however, advancements in high-
explanations. Investigating these areas holds the potential income countries now enable the diagnosis of CP before
for uncovering correlations between multiple conditions 6 months . The current clinical diagnosis of CP relies
[51]
and CP, thereby improving strategies for the prevention on the collective use of clinical presentations, physical
and management of clinical CP patients. assessments, and neuroimaging . Early diagnosis holds
[9]
Although the subset of patients with a history of significance as it facilitates early intervention during the
NE represents a small portion of the total CP patient earliest developmental stages of patients. The present
population, this specific cohort is disproportionately analysis posits a prospective preventive and therapeutic
affected by a higher incidence of severe CP-associated strategy for neonates exposed to NE-related conditions
complications than CP patients without a history of even before reaching 6 months, aiming to reduce the
NE. Previous studies have suggested that the increased development of CP. There is currently no specific therapy
incidence of CP in neonates who experienced NE-related available for CP patients who have experienced NE. For
conditions at birth indicates a heightened vulnerability instance, in the cases of CP children with NE suffering
among neonates afflicted by NE [9,51] . In this analysis, we from pronounced communication difficulties, existing
incorporated considerations for sex differences, utilizing clinical strategies to support communication skills are
studies that separately reported the number of CP cases for limited to supplementing or replacing functional oral
each sex. While our findings do not indicate a statistically communication rather than actively assisting patients
significant difference in the incidence of NE-associated in developing functional oral communication skills.
CP between male and female patients, it is crucial to Augmentative and alternative communication (AAC) [55,56] ,
acknowledge the limitations of our analysis, which stem a commonly employed clinical intervention for patients
from the restricted number of studies reporting CP cases with severe communication disabilities, enhances patients’
by sex. Notably, earlier studies have reported that male interaction with others through the use of manual signs,
patients tend to suffer from a more severe form of NE and gestures, pointing, pictures, boards, books, and speech-
exhibit more pronounced long-term cognitive deficits than generating devices [56,57] . However, AAC’s efficacy is highly
their female counterparts [52,53] . A population-based study dependent on auditory, visual, cognitive, and upper limb
has also highlighted that CP subsequent to NE is more function [56,58] , all of which were identified, in the present
likely to affect males and manifest with greater severity analysis, to be exacerbated in CP patients with preceding
than in females . To comprehensively discern potential NE conditions. This observation suggests that the potential
[33]

Volume 2 Issue 4 (2023) 8 https://doi.org/10.36922/an.1719