Cerebral Palsy in Children of Very Low Birth Weight

It has been known since Littles time that a high proportion of children with cerebral palsy are premature and that many are very small at birth. A study of the relation between the group of dis-orders included under the term cerebral palsy and very low birth weight was undertaken in the hope that it might contribute useful aetiological infor-mation. This report describes the results of a survey, made in collaboration with the Society of Medical Officers of Health, of 1,081 surviving children weighing not more than 4 lb. (1,800 g.) at birth. Taking into account the frequency of so low a birth weight, and the high mortality that it carries (Gibson and McKeown, 1951), it is estimated that this number of survivors was probably derived from about 230,000 live births. Review of Literature Differences in terminology and classification make comparisons between surveys difficult, but approxi-mately one-third of all cerebral palsy takes the form of spastic hemiplegia, one-third to one-half spastic diplegia or tetraplegia, and between one-tenth and one-quarter choreoathetosis. In premature children the commonest form is symmetrical spasticity affecting lower limbs more than upper limbs. When this is apparently limited to the lower limbs it is often called cerebral spastic paraplegia and when in addition upper limbs are affected, spastic diplegia or tetraplegia. Between 40 and 700 % of children with paraplegia and between 25 and 45 % of children with diplegia or tetraplegia have been reported to have a birth weight of not more than 51 lb. (2,500 g.)