Cerebral Palsy Associated With Neonatal Encephalopathy: Review of Te Rēhita a Hōkai Nukurangi Aotearoa-The New Zealand Cerebral Palsy Register (NZCPR) Data.

Background: In Aotearoa New Zealand (AoNZ), the cerebral palsy (CP) register (NZCPR) has collected national data since 2015. The dataset includes ethnicity and region of domicile; clinical characteristics; plus data on CP distribution and severity including GMFCS. Neonatal encephalopathy (NE) and hypoxic ischaemic encephalopathy (HIE) are potential causes of CP, so NZCPR data may assist prognostic counselling of whānau (family).

Methods: The NZCPR dataset was interrogated to identify individuals born between 1992 and 2020 inclusive, with NE/HIE as a potential cause of CP plus consent for research. The dataset was reviewed for evidence of other potential aetiologies for the CP and these plus preterm infants < 35 weeks gestation were excluded. The distribution and severity of the CP for the NE/HIE cohort was then determined.

Results: In total, 139 records were identified with NE/HIE as the likely CP aetiology, after exclusion of other conditions including childhood cardiac arrest, meningitis, bilirubin encephalopathy, hypoglycaemic injury and metabolic diseases. The median (IQR) birth gestation was 40 (38, 40) weeks and median (IQR) birth weight was 3330 (2910, 3650) g. Ten (7%) had died and approximately 70% were Gross Motor Function Classification System (GMFCS) Level IV or V, with quadriparesis as the most common distribution (63%). Associated other morbidities included epilepsy (47%), intellectual impairment (45%), severe visual problems (18%) or non-verbal (34%). ACC cover was approved in circa 40.5%.

Conclusions: In this novel dataset, if CP occurs after NE/HIE it is frequently severe affecting four limbs and associated with other morbidities.