Birth weight, subsequent growth, and cholesterol metabolism in children 8-12 years old born preterm

AIMS—To test the hypothesis that plasma lipids, lipoproteins, and markers of cholesterol biosynthesis (lathosterol) and absorption efficiency (campesterol) in children aged 8-12 years are related to birth size and subsequent growth.
METHODS—A total of 412 girls and boys weighing less than 1850 g at birth were studied. Birth weight, gestation, and weight at 18 months were recorded and followed up at 8-12 years. Plasma total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B, triacylglycerol, lathosterol, and campesterol were measured.
RESULTS—Birth weight for gestational age was positively related to plasma campesterol, and remained so after adjusting for current body size or fatness. Birth weight was negatively related to current plasma lathosterol but only after adjusting for current body size or fatness. For both lathosterol and campesterol the significant relation with birth size adjusted for current size indicates that the change in size between these points (postnatal upward centile crossing) was influential. These relations were absent for total cholesterol, lipoproteins, apolipoproteins, and triacylglycerol.
CONCLUSION—Preterm children who were smaller for gestational age at birth had lower predicted cholesterol absorption efficiency 8-12 years later. Among children of the same current size, predicted endogenous cholesterol synthesis was higher and cholesterol absorption efficiency lower in those who showed the greatest increase in weight centile between birth and follow up. This finding was not confined to children with the smallest birth weights for gestational age. We suggest that both fetal and childhood growth relate to programming of cholesterol metabolism in children born preterm.
     

Cholesterol metabolism in 8 to 12-year-old children born preterm or at term

Studies in animals have indicated that cholesterol metabolism is susceptible to manipulation by diet and growth in early life. In humans, low birthweight has been associated with increased risk of coronary heart disease. AIM: To establish whether plasma lipids and indicators of cholesterol absorption, synthesis and breakdown differ in children born preterm and at term. METHODS: Plasma total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triacylglycerols, apolipoprotein A1, apolipoprotein B, lathosterol (indicator of cholesterol synthesis), campesterol (indicator of cholesterol absorption), 7-alpha hydroxycholesterol (indicator of cholesterol breakdown) were measured in up to 407 children born preterm and 36 children born at term. RESULTS: Children born preterm had lower cholesterol synthesis (p = 0.002) and lower cholesterol breakdown (p < 0.001) than those born at term, but their plasma cholesterol concentration was not significantly different. After adjusting for current size, birthweight and gestational age were significantly related to plasma lathosterol and 7-alpha hydroxycholesterol. However, when both birthweight and gestational age were adjusted, only gestational age remained significant. There were no significant differences in plasma campesterol between the two groups. CONCLUSION: Being born preterm may have a long-term effect on cholesterol metabolism in children 8-12 y later. Those born prematurely had lower cholesterol synthesis and breakdown, but their plasma cholesterol concentration was similar at this age. These parameters need to be studied in older cohorts.     

The association between low birth weight and high levels of cholesterol is not due to an increased cholesterol synthesis or absorption: analysis in twins

Low birth weight may be associated with high levels of cholesterol in later life through genetic factors that affect both birth weight and cholesterol metabolism. Alterations in cholesterol synthesis and absorption may play an important role in this association. We examined birth weight and plasma ratios of a precursor of cholesterol, lathosterol (an estimate of cholesterol synthesis), and plant sterols, campesterol and beta-sitosterol (estimates of cholesterol absorption), to cholesterol in 53 dizygotic and 58 monozygotic adolescent twin pairs. After adjustment for current weight, birth weight was not associated with the ratios of lathosterol, campesterol, and beta-sitosterol either in the overall sample [+0.07 micro mol/mmol/kg (95% confidence interval: -0.11 to 0.25), p = 0.5; +0.02 micro mol/mmol/kg (-0.33 to 0.37), p = 0.9; and -0.04 micro mol/mmol/kg (-0.23 to 0.15), p = 0.8, respectively] or in the intrapair analysis in dizygotic twins [+0.27 micro mol/mmol/kg (-0.28 to 0.82), p = 0.3; -0.03 micro mol/mmol/kg (-1.07 to 1.01), p = 1.0; and +0.04 micro mol/mmol/kg (-0.56 to 0.64), p = 0.9, respectively] or in the intrapair analysis in monozygotic twins [+0.54 micro mol/mmol/kg (-0.09 to 1.18), p = 0.09; -0.60 micro mol/mmol/kg (-1.59 to 0.39), p = 0.2; and -0.43 micro mol/mmol/kg (-0.99 to 0.14), p = 0.14, respectively]. Plasma levels of lathosterol, campesterol, and beta-sitosterol, which are indicators of cholesterol synthesis and absorption, thus do not explain the association of low birth weight with high levels of total and LDL cholesterol. As an alternative hypothesis, we suggest that a decrease in cholesterol clearance may play an important role.     

Squalene and noncholesterol sterols in serum and lipoproteins of children with and without familial hypercholesterolemia

Squalene and noncholesterol sterols, e.g. lathosterol and plant sterols, the respective markers of cholesterol synthesis and absorption, are transported with cholesterol in serum lipoproteins. Their concentrations and ratios to cholesterol in serum and lipoproteins have not been carefully compared, especially in children and in marked hypercholesterolemia. Thus, we measured these variables with gas-liquid chromatography in 18 children with and 29 without familial hypercholesterolemia, all aged 5-17 y. Concentrations of most noncholesterol sterols were higher in serum, LDL, and intermediate density lipoprotein in the children with than those without familial hypercholesterolemia. Despite accumulation of noncholesterol sterols mainly in LDL (75% in familial hypercholesterolemia and 55% in non-familial hypercholesterolemia, p < 0.001), their ratios were mostly similar in serum and lipoproteins of the two groups. The ratios of squalene and lathosterol were higher in VLDL and intermediate density lipoprotein, whereas in LDL that of lathosterol was lower than the respective serum values in both groups. Absorption marker sterol ratios were highest in HDL in both groups. Thus, even though the ratios of noncholesterol sterols to cholesterol in serum reflect, in general, synthesis and absorption of cholesterol, their ratios in different lipoproteins could give additional information of cholesterol metabolism.     

Effects of dietary cholesterol on plasma lipoproteins in Smith-Lemli-Opitz syndrome

Smith-Lemli-Opitz syndrome is a condition of impaired cholesterol synthesis that is caused by mutations in DHCR7 encoding 7-dehydrocholesterol-Delta7 reductase. Birth defects and mental retardation are characteristic. Deficient plasma and tissue cholesterol and excess cholesterol precursors 7 and 8 dehydrocholesterol (7DHC and 8DHC) contribute to the pathogenesis. Cholesterol is transported to tissues via lipoproteins. We measured the effect of dietary cholesterol (egg yolk) on plasma lipoproteins to evaluate this potential treatment. We used the enzymatic method to measure total sterols in lipoproteins (n=12) and plasma (n=16). In addition, we analyzed individual plasma sterols by a gas chromatographic method. Samples were evaluated after 3 wk of a cholesterol-free diet and after 6-19 mo of dietary cholesterol. We also analyzed the distribution of sterols in lipoproteins and the apolipoprotein E genotype. Dietary cholesterol significantly increased the total sterols in plasma (2.22 +/- 0.13 to 3.10 +/- 0.22; mean +/- SEM; p < 0.002), in LDL (0.98 +/- 0.13 to 1.52 +/- 0.17 mM), and in HDL (0.72 +/- 0.04 to 0.92 +/- 0.07). Plasma cholesterol increased (1.78 +/- 0.16 to 2.67 +/- 0.25 mM; p < 0.007) and plasma 7DHC decreased in 10 children, but the mean decrease was not significant. The distribution of individual sterols in each lipoprotein fraction was similar to the distribution in plasma. The baseline cholesterol and the response to dietary cholesterol was the same in children with 3/3 and 3/4 apolipoprotein E genotypes. Dietary cholesterol increased total sterols in plasma, LDL, and HDL in children with Smith-Lemli-Opitz syndrome. These favorable increases in the lipoproteins are potentially therapeutic for this condition.     

Weight gain in childhood and blood lipids in adolescence

Aim: To assess the effect of weight gain in childhood on blood lipid levels in adolescence.
Methods: A population-based birth cohort carried out in Pelotas, Southern Brazil. All newborns in the city's hospitals were enrolled in 1982. The subjects have been followed up for several times in childhood. At age 18, 79% of all males were followed, and 2083 blood samples were available. Adjusted analyses controlled for household assets index, family income, parental schooling at birth, maternal smoking during pregnancy and breastfeeding duration.
Results: Birth weight for gestational age and weight gain in the first 20 months was not associated with blood lipid levels in adolescence. On the other hand, those subjects whose weight gain from 20 to 42 months of age was faster than that predicted from birth weight and weight-for-age z-score at the mean age of 20 months had lower high-density lipoprotein cholesterol (HDL) cholesterol [−0.78 (95% confidence interval: −1.28; −0.29)] and higher very low-density lipoprotein cholesterol (VLDL) and low-density lipoprotein cholesterol (LDL)/HDL ratio in adolescence. After controlling for current body mass index (BMI), the regression coefficient for HDL cholesterol decreased from −0.78 mg/dL to −0.29 mg/dL (95% confidence interval: −1.00 to 0.05).
Conclusion: Weight gain from 2 to 4 years is related to an atherogenic lipid profile in adolescence and this association is mediated by current BMI.     

Growth and very low birth weight.

Information on the likelihood of catch up growth in poorly grown very low birthweight children is sparse. The centiles for weight, height, and head circumference were recorded at both 2 and 5 years of age for 135 very low birthweight children and 42 normal birthweight children. At both ages significantly more children of very low birth weight were under the 10th centile for weight and height. Children of birth weight under 1000 g were more often under the 10th centile for weight at 5 years compared with those of birth weight 1000-1500 g. Mean incremental weight gain between 2 and 5 years was significantly less for very low birthweight children. Mean increment in weight from 2 to 5 years was less for very low birthweight children who had been under the 10th centile for weight at 2 years; children who had been under the 10th centile for height also had lower mean height increments. The growth centiles achieved by 2 years of age were useful predictors of poor growth at 5 years, with perinatal data of marginal importance. Only six of 43 (14%) children with a weight at 5 years of age under the 10th centile were small for gestational age at birth. Very low birthweight children who had a weight or height under the 10th centile at 2 years of age usually remained in this category at 5 years with no evidence of catch up growth.     

Lipoprotein changes in small-for-gestational-age infants fed nucleotide-supplemented milk formula

Morillas J, Moltó L, Robles R, Gil A, Sánchez-Pozo A. Lipoprotein changes in small-for-gestational-age infants fed nucleotide-supplemented milk formula. Acta Prediatr 1994;83:481–5. Stockholm. ISSN 0803–5253
We determined the effect of supplementing milk formula with nucleotides on plasma lipoproteins in small-for-gestational-age infants: 21 infants were fed a nucleotide-supplemented formula and 20 infants were fed the same nucleotide-free formula. On days 0, 3 and 7 after birth, major plasma lipoprotein fractions were analyzed for apolipoprotein and lipid composition. Compared with the control group, the group receiving nucleotides had increased total apoprotein concentrations in all lipoproteins as well as increased apo A-I in high-density lipoproteins and very low-density lipoproteins, and apo B-100 in very low-density lipoproteins and low-density lipoproteins. Very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol and very low-density lipoprotein triglycerides increased in parallel to the changes in apoproteins. The cholesterol ester to unesterified cholesterol ratio was increased in low-density lipoproteins and, particularly, in high-density lipoproteins. These data support the hypothesis that lipoprotein metabolism in small-for-gestational-age infants is affected by dietary nucleotide supplementation, enhancing lipoprotein synthesis or secretion. Cholesterol esterification capacity paralleled the apo A-I increase, in agreement with the co-factor role of apo A-I on lecithin: cholesterol acyltransferase.     

Serum lipids and apolipoproteins in Spanish children and adolescents: a 5 year follow-up

This study was designed to assess "tracking" of serum lipids and apolipoproteins in three age groups of Spanish children over a 5 year period. A total of 84 6-year-old, 89 10-year-old and 64 14-year-old children were evaluated in 1989 (with measurement of serum total cholesterol, triglycerides, lipoproteins and apolipoproteins A1 and B), and re-evaluated in 1994. Correlation coefficients between initial and final lipid and apolipoprotein values were as follows: total cholesterol, 0.66; low-density lipoprotein (LDL) cholesterol, 0.65; high-density lipoprotein (HDL) cholesterol, 0.61; triglycerides, 0.61; apolipoprotein A1, 0.60; apolipoprotein B, 0.66. When age groups were analysed separately, children who were 14 years old at the beginning of the study showed higher correlation coefficients, particularly for total cholesterol and LDL cholesterol (> 0.7 in both cases). More than 70%, of children who were in the top quintile of total, LDL or HDL cholesterol as well as apolipoprotein A1 or B in 1989 remained in the top quintile 5 years later.     

Does low birth weight affect the presence of cardiometabolic risk factors in overweight and obese children?

Recent findings suggest that low-birth-weight children with current obesity are more likely to have higher systolic blood pressure levels and impaired β-cell function than those who are obese with normal birth weight. It seems possible, however, that concurrent low birth weight with excess weight gain can exacerbate other risk factors for cardiometabolic diseases. The purpose of this study is to investigate the influence of birth weight on the lipid/apolipoprotein profile, visfatin levels, and insulin parameters in overweight/obese children. A cross-sectional study of 68 overweight/obese children was conducted. Among these children, 28 were identified with low birth weight and 40 were of normal birth weight. Blood lipid profile, apolipoproteins, visfatin, glucose, and insulin were measured. Our results show that systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels, triglycerides (TG), very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDLc), apolipoprotein B and E, insulin, apolipoprotein B/A₁ ratio, and homeostasis model assessment insulin resistance (HOMA-IR) were significantly elevated in overweight/obese low-birth-weight (LBW) children. There was a significant association of the SBP levels with TG (P?=?0.027), LDLc (P?=?0.001), HOMA-IR (P?<?0.001), apolipoprotein B (P?=?0.001), and apolipoprotein E (P?=?0.039). Conclusion: Our findings suggest that LBW children with overweight or obesity have an additional risk factor for both atherogenic and insulinogenic profile.     

High density lipoprotein-cholesterol changes in children with high cholesterol levels at birth

The predictive value of serum lipoprotein concentrations at birth for the same parameters later in life is under debate. A group of 20 children displaying high total cholesterol (TC) levels at birth (group 2) were compared at age 4 years with 18 control children who had presented a normal lipoprotein profile at birth (group 1). There was a significant correlation between TC, low density lipoprotein-cholesterol, high density lipoprotein (HDL)-cholesterol, and apolipoprotein (Apo) A-I levels at age 4 years and at birth. The increases in TC and HDL-cholesterol levels from birth to age 4 years were significantly lower (P < 0.05, P < 0.01, respectively) in group 2 than in the control group and inversely correlated with the concentrations of these parameters at birth. The increases in HDL-cholesterol and Apo A-I levels were higher in males while those of triacylglycerol and Apo B were higher in females (P < 0.05). However, the increases in TC and HDL-cholesterol were higher in controls (P< 0.05). Diets of children of both groups were similar regarding the energy contribution of saturated, monounsaturated and polyunsaturated fatty acids, although children from group 2 ate less fish and omega-3 fatty acids (P < 0.05). CONCLUSION: the present data suggest for the first time that when high density lipoprotein-cholesterol levels are high at birth, those levels increase less during the first four years of life. Moreover, low density lipoprotein-cholesterol increased about five times as much as high density lipoprotein-cholesterol did in controls and about 15 times as much as in the children with high cholesterol at birth.     

Should children with infection be tested for lipid,lipoprotein and apolipoprotein?

The lipid profile is known to alter in patients with infection, but there has not been a study of the apolipoprotein levels in serum of otherwise healthy children during infection. Lipids, lipoproteins, apolipoproteins A-l and B and lipoprotein (a) were evaluated prospectively in 31 consecutive children, aged4–15 years, who were admitted to the hospital with bacterial pharyngitis. The degree of dyslipidemia associated with bacterial pharyngitis was assessed using each child as his/her own control and by comparison with 79 healthy children who had not had an infection during the past 3 months. Serum total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A-l and apolipoprotein B levels were significantly decreased during the symptomatic phase of the disease, whereas the serum triglyceride level was slightly elevated. Serum lipoprotein (a) concentration did not change significantly. In conclusion, it is suggested that serum lipids, lipoproteins and apolipoproteins should not be assessed during infection because of the possible transient changes of these parameters during infection or inflammation.     

大于胎龄儿脐血脂联素水平测定及其临床意义

目的探讨大于胎龄儿(LGA)血脂联素水平变化及其对新生儿的影响。方法研究对象为LGA和适于胎龄儿(AGA)各30例。应用酶联免疫吸附法(ELISA)测定脐血和产妇血脂联素水平,用免疫比浊法测定三酰甘油(TG)、总胆固醇(TCH)、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)水平,并分析脐血脂联素水平与母血脂联素、新生儿性别、出生体质量、体质量指数(BMI)、胎盘重量和血脂水平的相关性。结果1.LGA脐血浆脂联素水平低于AGA,差异有非常显著性(P<0.01);LGA血TG、TCH、LDL-c、HDL-c水平与AGA比较差异均无显著性(Pa>0.05)。2.LGA血浆脂联素水平与新生儿出生体质量、BMI、胎盘重量、脐血TG水平均呈显著负相关(r=-0.848,-0.785,-0.835 Pa<0.001),与母血脂联素水平、新生儿身长、孕前和分娩时产妇体质量及其BMI、其他脐血脂成分无相关性(Pa>0.05)。3.LGA男婴和女婴脐血浆脂联素、血脂各成分水平比较差异均无显著性(Pa>0.05)。结论血脂联素水平变化与LGA的发生有关,测定脐血脂联素水平有助于判断LGA的发展趋势。     

Concentration of twelve plasma proteins at birth in very low birthweight and in term infants

Plasma samples obtained at birth from 70 very low birth weight (VLBW) infants (gestational age 24 to 34 weeks) and from 20 term infants were analysed for concentrations of 12 different proteins. The plasma concentrations of albumin, transthyretin (TTR), retinol-binding protein (RBP), vitamin D-binding protein, apolipoprotein A I, fibronectin, orosomucoid and alpha 1-antichymotrypsin were significantly lower in the VLBW infants than in the term infants, whereas the values of alpha-fetoprotein (AFP) were significantly higher in the VLBW infants. No differences were found between the two groups for apolipoprotein A II, apolipoprotein B and transferrin. Birth asphyxia and sex had no influence on the measured plasma protein concentrations. The plasma concentrations of apolipoprotein A I and A II were significantly lower in small-for-gestational age (SGA), VLBW infants compared with appropriate-for-gestational age (AGA), VLBW infants. Possible acute inflammation (defined as raised concentrations of orosomucoid or alpha 1-antichymotrypsin) was associated with significantly higher values of vitamin D-binding protein in both VLBW and term infants, suggesting that this protein may act as an acute phase protein in newborn infants.     

Prenatal predictors of chronic lung disease in very preterm infants

OBJECTIVE: To identify prenatal risk factors for chronic lung disease (CLD) at 36 weeks postmenstrual age in very preterm infants. POPULATION: Data were collected prospectively as part of the ongoing audit of the Australian and New Zealand Neonatal Network (ANZNN) of all infants born at less than 32 weeks gestation admitted to all tertiary neonatal intensive care units in Australia and New Zealand. METHODS: Prenatal factors up to 1 minute of age were examined in the subset of infants born at gestational ages 22-31 weeks during 1998-2001, and who survived to 36 weeks postmenstrual age (n = 11 453). Factors that were significantly associated with CLD at 36 weeks were entered into a multivariate logistic regression model. RESULTS: After adjustment, low gestational age was the dominant risk factor, with an approximate doubling of the odds with each week of decreasing gestational age from 31 to less than 25 weeks (trend p<0.0001). Birth weight for gestational age also had a dose-response effect: the lower the birth weight for gestational age, the greater the risk, with infants below the third centile having 5.67 times greater odds of CLD than those between the 25th and 75th centile (trend p<0.0001). There was also a significantly increased risk for male infants (odds ratio 1.51 (95% confidence interval 1.36 to 1.68), p<0.0001). CONCLUSIONS: These population based data show that the prenatal factors low gestational age, low birth weight for gestational age, and male sex significantly predict the development of chronic respiratory insufficiency in very preterm infants and may assist clinical decision about delivery.     

Effects of ileum transplantation and chronic rejection on absorption and synthesis of cholesterol in pigs

We investigated the effects of ileum allotransplantation and chronic graft rejection on the synthesis and absorption of cholesterol. Twenty pigs underwent intestinal transection or ileum transplantation, in which the distal half of the jejunoileum was replaced with an ileal autograft or allograft. Conventional triple therapy with cyclosporine (10 mg/kg per day), azathioprine and methylprednisolone was tapered to cyclosporine (5 mg/kg per day) after 10 weeks. Serum lathosterol and campesterol, respective markers of cholesterol synthesis and absorption, were determined and related to graft histology. When compared to transected controls, auto- and allotransplantation of ileum similarly increased ( P<0.05) lathosterol and decreased ( P<0.01) campesterol for 12 weeks, despite normal graft histology. Chronic graft rejection progressed between 12 and 18 weeks, when a further increase in lathosterol (+104%) and decrease in campesterol (-67%) was observed. Obliteration of mesenterial arteries in chronically rejecting grafts was associated with high cholesterol synthesis ( R=0.975, P=0.0512). Auto- and allotransplantation of the ileum similarly modulate synthesis and absorption of cholesterol in pigs with non-rejecting grafts. Chronic rejection of the ileal graft appears to markedly increase cholesterol synthesis, which may primarily result from impaired ileal reabsorption of bile acids due to gradual obliteration of mesenterial arteries (chronic rejection). Serial measurements of cholesterol synthesis and bile acid absorption may prove to be a useful tool in the diagnosis of chronic rejection-associated small intestinal graft dysfunction.     

Lipids, lipoproteins and apolipoproteins AI, AII, B, CII, CIII and E in newborns.

In this study lipid and apolipoprotein patterns were investigated at birth and compared with those of adults. In cord sera, cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol were 38.2, 46.2, 50.5, and 31.9%, respectively, of adult values. Apolipoprotein AII, B and CIII were 48.6, 30.6 and 44.5% of adult values, while apo AI, apo CII and apo E showed values approaching those of adults (63.4, 73.3 and 89.7%, respectively). Also cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratios were lower in newborns. In cord sera, lipids were correlated with various apolipoproteins in a surprisingly different way from adult sera. HDL cholesterol was not inversely correlated with triglycerides, and showed a highly positive correlation with apo E, apo CII and apo CIII, which did not correlate with HDL cholesterol in adults. These data supported the presence of significant differences in plasma concentrations and composition of lipoproteins at birth. Therefore HDL, apo CII, and apo E seem to play a different and more important metabolic role in neonatal lipid metabolism.     

Concentration of Twelve Plasma Proteins at Birth in Very Low Birthweight and in Term Infants

ABSTRACT. Plasma samples obtained at birth from 70 very low birth weight (VLBW) infants (gestational age 24 to 34 weeks) and from 20 term infants were analysed for concentrations of 12 different proteins. The plasma concentrations of albumin, transthyretin (TTR), retinol-binding protein (RBP), vitamin D-binding protein, apolipoprotein A I, fibronectin, orosomucoid and α₁-antichymotrypsin were significantly lower in the VLBW infants than in the term infants, whereas the values of α-fetoprotein (AFP) were significantly higher in the VLBW infants. No differences were found between the two groups for apolipoprotein A II, apolipoprotein B and transferrin. Birth asphyxia and sex had no influence on the measured plasma protein concentrations. The plasma concentrations of apolipoprotein A I and A II were significantly lower in small-forgestational age (SGA), VLBW infants compared with appropriate-for-gestational age (AGA), VLBW infants. Possible acute inflammation (defined as raised concentrations of orosomucoid or α₁-antichymotrypsin) was associated with significantly higher values of vitamin D-binding protein in both VLBW and term infants, suggesting that this protein may act as an acute phase protein in newborn infants.     

Birth weight and gestational age in children with cerebral palsy or seizure disorders

Birth weight and gestational age of single-born children with cerebral palsy (CP) and those with seizure disorders were compared with norms for 40,000 single-born children in the same prospectively identified population. Low birth-weight and short gestation were important risk factors for CP, but these characteristics were uncommon, and the majority of children with CP were of normal birth weight and term gestational age. Preterm children with CP by age 7 years tended to have been even smaller at birth than was appropriate for their short gestions. Among term infants with later CP, the birth weights of the majority were appropriate for dates, but a subgroup were noticeably small for dates at term. Low birth weight, preterm birth, and smallness for dates at term were not significantly related to the risk of seizure disorders in children free of CP.