The type and severity of cerebral palsy (CP) and pattern of associated disability in children with or without preceding neonatal encephalopathy (NE) were compared in a population-based case-control study of patients followed for 6 years at the Children’s Hospital, Westmead, Sydney, Australia. Of 276 infants with NE, 25 (9.1%) died in the neonatal period, and of the 251 neonatal NE survivors, 32 (13%) developed CP by 5 years of age. Of term infants with CP, 24% followed NE. CP following NE was more likely in males, more severe, spastic quadriplegic in type, and more commonly complicated by cognitive and speech impairment, epilepsy, severe disability, and death by 6 years. [1]

COMMENT. Term infants with CP and NE have a poorer prognosis compared to those without NE. One out of every five will die in the first 5 years of life. In a commentary by Dr Karin B Nelson, National Institutes of Health, USA [2], the importance of causal factors in NE was stressed, a subject addressed by the authors in a previous study. [3]