Abstract
We analyzed the gestational, parturitional, neonatal (GPN) histories of 281 severely mentally retarded patients with cerebral palsy to define the etiology or pathogenesis of cerebral palsy in each patient. No association between type of cerebral palsy and GPN histories was found except for an increase in spastic-athetoid patients in the breech delivery subgroup. Significant findings include: increased incidence of prematurity and postmaturity, small and large for-gestational age (GA) fetal size, a normal birthweight for GA distribution of patients with diabetic mothers, an excess of mothers ≥35 and ≤20 years old, an increased immediately-previous sib interval of 2.59 years suggestive of an “infertility factor”, an unremarkable GPN history in one third of the cases, in another one third GPN problems not usually associated with a high risk of CNS damage, and in one third gross complications which were probably responsible for the CP, including: an increased incidence of breech deliveries, twinning, prolonged and precipitous labor and placental complications; no increased association of athetosis and Rh incompatibility or incidence of toxemia was found. Disseminated intravascular coagulation due to prenatal death of a twin may have been the cause of brain damage in several patients.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Busby, T.: The duration of labor: mean, mode and median. Amer. J. Obstet. Gynec. 55, 846–851 (1948)
Child, B., Evans, P. R.: Birthweights of children with cerebral palsy. Lancet 1954 I, 642–645
Collier, J. S.: The pathogenesis of cerebral diplegia. Lancet 1932 II, 1129–1132
Crothers, B., Paine, R. S.: The natural history of cerebral palsy. Cambridge: Harvard University Press 1959
Durkin, M. V., Kaveggia, E. G., Pendleton, E., Opitz, J. M.: Twinning and illegitimacy in CNS defect. Lancet 1974 II, 1389–1390
Eastman, N. M., Hellman, L. M.: Williams obstetrics, 12th ed. New York: Appleton-Century-Crofts, Inc. 1966
Ford, F. R.: Cerebral birth injuries and their results. Medicine (Baltimore) 5, 121–194 (1926)
Friedman, E. A.: Primagravid labor: a graphicostatistical analysis. Obstet. and Gynec. 6, 567–589 (1955)
Friedman, E. A.: Labor in multiparas: a graphicostatistical analysis. Obstet. and Gynec. 8, 691–703 (1956)
Fuldner, R. V.: Labor complications and cerebral palsy. Amer. J. Obstet. Gynec. 74, 159–166 (1957)
Griffith, M.: Cerebral palsy in multiple pregnancies. Develop. med. Child. Neurol. 9, 713–731 (1967)
Ingram, T. T. S.: Pediatric aspects of cerebral palsy. Edinburgh-London: E. and S. Livingstone, Ltd. 1964
Kaveggia, E. G., Durkin, M. V., Pendleton, E., Opitz, J. M.: Diagnostic/genetic studies in 1224 patients with severe mental retardation. In: Proc. of the 3rd International Congress of the International Association of the Scientific Study of Mental Deficiency, pp. 82–93. Warsaw: Polish Medical Publishers 1971a
Kaveggia, E. G., Opitz, J. M., Pallister, P. D.: Diagnostic/genetic studies in severe mental retardation. In: Proc. of the 2nd International Congress of the International Association of the Scientific Study of Mental Deficiency, pp. 305–312. Warsaw: Polish Medical Publishers 1971b
Koranyi, G., Kovacs, J.: Über das Zwillingstransfusionssyndrom. Acta paediat. Acad. Sci. hung. 16, 119–125 (1975)
Little, W. J.: On the influence of abnormal parturition, difficult labor, premature birth, and asphyxia neonatorum on the mental and physical condition of the child. Lancet 1861 II, 378–380
Lubchenco, L. O., Delivoria-Papadopoulos, M., Searles, D.: Long-term follow-up studies of prematurely born infants. II. Influence of birthweight and gestational age on sequelae. J. Pediat. 80, 509–512 (1972)
MacDonald, A.: Children of very low birthweight: a survey of 1128 children with a birthweight of 4 pounds or less. Medical Education and Information Unit Research Monograph No. 1. London: William Heinemann Medical Books, Ltd. 1967
Moore, C. M., McAdams, A. J., Sutherland, J.: Intrauterine disseminated intravascular coagulation: a syndrome of multiple pregnancy with a dead twin fetus. J. Pediat. 74, 523–528 (1969)
Moser, H. W., Wolf, P. A.: The nosology of mental retardation: including the report of a survey of 1378 mentally retarded individuals at the Walter E. Fernald State School. Birth Defects Original Article Series 7, 117–134 (1971)
Opitz, J. M.: Diagnostic/genetic studies in severe mental retardation. Presented at the NICHHD Genetic Counseling meeting, Colorado Springs 1975. In press
Opitz, J. M., Kaveggia, E. G., Pallister, P. D.: Studies of genetic malformation/retardation syndromes. In: Proc. of the 2nd International Congress of the International Association of the Scientific Study of Mental Deficiency, pp. 115–119. Warsaw: Polish Medical Publishers 1971
Pallister, P. D., Kaveggia, E. G., Inhorn, S. L., Meisner, L., Opitz, J. M.: Chromosome studies in malformation/retardation syndromes. In: Proc. of the 2nd International Congress of the International Association of the Scientific Study of Mental Deficiency, pp. 313–322. Warsaw: Polish Medical Publishers 1971
Reismann, L. E., Pothak, A.: Bilateral renalcortical necrosis in the newborn. Amer. J. Dis. Child. 111, 541–543 (1966)
Willson, J. R., Beecher, C. T., Carrington, E. R.: Obstetrics and gynecology, 4th ed. St. Louis: C. V. Mosby Company 1971
Author information
Authors and Affiliations
Additional information
Supported by USPHS Grants GM15422, 5KO4HD18982 and GM20130, and by a Grant from the Wisconsin Department of Health to Central Wisconsin Colony and Training School (CWC) in support of the CWC Diagnostic and Genetic Counseling Unit. This is paper No. 1985 from the University of Wisconsin Genetics Laboratory
Rights and permissions
About this article
Cite this article
Durkin, M.V., Kaveggia, E.G., Pendleton, E. et al. Analysis of etiologic factors in cerebral palsy with severe mental retardation. Eur J Pediatr 123, 67–81 (1976). https://doi.org/10.1007/BF00442637
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00442637