Defining the true pathogenesis and pathophysiology of neonatal encephalopathy and cerebral palsy

TY - JOUR

T1 - Defining the true pathogenesis and pathophysiology of neonatal encephalopathy and cerebral palsy

AU - Speer, Michael

AU - Hankins, Gary D.V.

N1 - Funding Information: antepartum abnormalities, is estimated to be approximately 1.6 per 10,000 infants.2,3 It can also be stated with certainty that the pathway from an intrapartum hypoxic–ischemic injury to subsequent cerebral palsy must progress through neonatal encephalopathy2,3 and that hypoxic-ischemic encephalopathy is but a minor component of the broader diagnostic category of neonatal encephalopathy. Criteria to define an acute intrapartum hypoxic event as sufficient to cause cerebral palsy, based on scientific evidence, were first proposed by the American College of Obstetricians and Gynecologists (ACOG).6 As knowledge was advanced by research, criteria were further refined by the International Cerebral Palsy Task Force Consensus Statement.7 Most recently, the criteria have again been reviewed and knowledge updated by the ACOG and American Academy of Pediatrics (AAP) Task Force on Neonatal Encephalopathy and Cerebral Palsy.8 The Task Force met over a 3 year period and utilized the services of expert consultants, concurrent literature review, as well as input and endorsement from many professional societies and organizations. The purpose of the Task Force was to define the current scientific evidence regarding the epidemiology, outcome, and etiology of neonatal encephalopathy. Review of the maternal risk factors, fetal considerations, antepartum events, and genetic conditions that could potentially serve as adverse events was undertaken. Also, a portion of the document is devoted to the assessment of the newborn infant including the relation of the following to neonatal outcome including cerebral palsy: umbilical artery pH, Apgar Score, role of neuroimaging and electroencephalography, placental pathology, nucleated red blood cells, and lymphocytic counts. Finally, a chapter on future directions summarizes possible therapies. The following organizations have reviewed and endorsed the document: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, the Child Neurology Society, the March of Dimes Birth Defects Foundation, the National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the Society for Maternal Fetal Medicine, and the Society of Obstetricians and Gynaecologists of Canada. Accordingly, the latter publication is the most extensively peer-reviewed document of this subject published to date. A description of the criteria required to define an acute intrapartum hypoxic event sufficient to cause cerebral palsy used in the Task Force Report is a modification of the International Cerebral Palsy Task Force Consensus Statement, A template for defining a causal relation between acute intrapartum events

PY - 2003/4

Y1 - 2003/4

UR - http://www.scopus.com/inward/record.url?scp=0038486047&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038486047&partnerID=8YFLogxK

U2 - 10.1038/sj.jp.7210912

DO - 10.1038/sj.jp.7210912

M3 - Editorial

C2 - 12732852

AN - SCOPUS:0038486047

SN - 0743-8346

VL - 23

SP - 179

EP - 180

JO - Journal of Perinatology

JF - Journal of Perinatology

IS - 3

ER -