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2019

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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CHILDREN WITH CEREBRAL PALSY BORN AT TERM, NON-ADMITTED TO NEONATAL INTENSIVE CARE, FROM THE PORTUGUESE NATIONAL REGISTER

Daniel Virella1, Teresa Folha2, Maria da Graça Andrada3, Ana Cadete4, Rosa Gouveia5, Teresa Gaia6, Joaquim Alvarelhão7, Eulália Calado8 on behalf of Programa de Vigilância Nacional de Paralisia Cerebral aos 5 Anos de Idade em Portugal (PVPC5A)

1- Centro de Investigação, Centro Hospitalar de Lisboa Central, Lisboa
2- Centro de Reabilitação de Paralisia Cerebral Calouste Gulbenkian, Lisboa
3- Programa Nacional Vigilancia Paralisia Cerebral
4- Departamento de Medicina Física e Reabilitação, Hospital Dr. Fernando Fonseca, Amadora
5- Sociedade Portuguesa de Pediatria do Neurodesenvolvimento
6- Centro de Paralisia Cerebral de Beja
7- Escola Superior de Saúde, Universidade de Aveiro
8- Serviço de Neurologia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisboa

VII Jornadas Internacionais de Neonatologia/XLV Jornadas Nacionais de Neonatologia, 2016

Aims. Most children with cerebral palsy (CP) are born at term; circa 10% of children with CP have an identified causal post-neonatal event. The characteristics of children with CP born at term, non-admitted to neonatal intensive care (NICU) are analysed.
Methods. Data from cross-sectional active surveillance of 5-years-old children with CP born in 2001-2009 were used. Children born and living in Portugal, born at term, with data on admission to NICU were included. SCPE definitions and functional classifications (GMFCS, BFMF, MACS, VSC, IQ, vision and hearing) were used, as well as Portuguese scales for assessment of feeding ability, drooling control and school inclusion. CP type was determined by the predominant clinical features. Children admitted and non-admitted to NICU were compared.
Results. From 1233 registered children born and living in Portugal, non-admission to NICU was reported in 318/557 children born at term children (57.1%; 95%CI 52.95-61.14). These children significantly less often were born by emergent caesarean section, had low Apgar score or early neonatal seizures; they had more often brain malformations and infections (congenital CMV) and an identified causal post-neonatal event was more frequent (18.5% vs. 2.2%). The profiles of clinical CP types and MRI findings were significantly different. Their functional evaluations were significantly better in every score. Epilepsy was less frequent (43.4% vs. 55.6%). Full or partial inclusion was more frequent (76.6% vs. 57.7%).
Conclusion. In Portugal, more than half of 5-years-old children with CP born at term had no significant neonatal events; their functional status is generally satisfactory.

Palavras Chave: cerebral palsy, term, surveillance