54. Neonatal Encephalopathy and Cerebral Palsy

  1. John T. Queenan MD4,
  2. Catherine Y. Spong MD5 and
  3. Charles J. Lockwood MD6
  1. Maged M. Costantine MD1,
  2. Mary E. D'Alton MD2,3 and
  3. Gary D. V. Hankins MD1

Published Online: 4 JAN 2012

DOI: 10.1002/9781119963783.ch54

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

How to Cite

Costantine, M. M., D'Alton, M. E. and Hankins, G. D. V. (2012) Neonatal Encephalopathy and Cerebral Palsy, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch54

Editor Information

  1. 4

    Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA

  2. 5

    Bethesda, MD, USA

  3. 6

    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Author Information

  1. 1

    Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA

  2. 2

    Department of Obstetrics and Gynecology, Columbia University Medical Center, NY, USA

  3. 3

    Columbia Presbyterian Hospital, New York, NY, USA

Publication History

  1. Published Online: 4 JAN 2012
  2. Published Print: 24 FEB 2012

ISBN Information

Print ISBN: 9780470655764

Online ISBN: 9781119963783

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Keywords:

  • neonatal encephalopathy and cerebral palsy;
  • neonatal encephalopathy, more than 37 weeks' gestation;
  • cerebral palsy, chronic neuromuscular disability;
  • risk factors, for newborn encephalopathy;
  • differential diagnosis, antecedants of neonatal encephalopathy;
  • criteria, acute intrapartum event in cerebral palsy;
  • task force on neonatal encephalopathy;
  • cerebral palsy prevention strategies;
  • implementation of neuroprotection

Summary

The incidence of cerebral palsy is 1–2 per 1000 births and has remained unchanged over the last 40 years. The occurrence of cerebral palsy is independent of either geographic or economic boundaries. It has also been remarkably resistant to eradication by the introduction of technology such as electronic fetal heart rate monitoring or the increase in cesarean delivery rates. Indeed, the great hope of electronic fetal heart rate monitoring was that intrapartum asphyxia would be promptly identified, delivery rapidly achieved, and neurologic injury of the infant averted. This would in fact parallel the thought processes advanced by the orthopedic surgeon Little, over a century ago, who taught that virtually all cerebral palsy was caused by intrapartum events, whether deprivation of oxygen, trauma, or the combination of the two. Unfortunately, despite an escalation of the cesarean delivery rate from approximately 6% in 1970 to a rate approaching 30% nationally today, the incidence of cerebral palsy in the USA has remained constant. These facts then would seem to support the evolving concept that cerebral palsy results from the combination of the genetic make-up of the individual and the subsequent collision of that individual during development with the environment that they are exposed to, both intrauterine as well as extrauterine for the first several days, months, or years of life.