The incidence of premature infants reached 11.1%

"Cerebral palsy refers to the syndrome caused by non progressive brain injury due to some reasons in the early stage of fetal or infant brain development, which is mainly manifested by central dyskinesia and abnormal posture, and can be accompanied by other symptoms such as mental retardation," said Zhang Xiufang, deputy chief physician of Pediatric Comprehensive Department of Shandong Qianfoshan Hospital, "Non progressive brain injury means that the disease will not worsen with age."

"There are many reasons for cerebral palsy, and premature birth can be said to be the first reason. Relevant surveys show that the incidence of cerebral palsy in small premature infants or very low birth weight infants whose gestational age is less than 32 weeks and birth weight is less than 1500 grams can reach 40-70 times that of full-term infants." said Hao Suyuan, chief pediatrician of Jinan Maternal and Child Health Hospital and expert in early intervention of high-risk infants. Due to immature brain development of premature infants, they are prone to suffer from some diseases after birth, such as dyspnea, hypoxia, intracranial hemorrhage, etc. In addition, premature infants are often undernourished, which also affects brain development.

According to the data recently released by the World Health Organization, the global incidence of premature infants is as high as 11.1%, which is even higher in developing countries and regions. There are many reasons for premature delivery, such as intrauterine infection, various pregnancy complications, and intrauterine fetal dysplasia. With the increasing incidence of infertility, more and more assisted reproductive technologies are available, and the phenomenon of multiple pregnancies is becoming more and more common. "Multiple pregnancies are likely to lead to poor fetal development, premature delivery, and increased probability of cerebral palsy."

In addition to premature delivery, the causes of cerebral palsy can be divided into three categories: prenatal, intrapartum and postpartum. Prenatal causes of cerebral palsy include maternal intrauterine infection, fetal brain abnormalities, congenital genetic metabolic diseases, etc; The causes during labor include fetal asphyxia, intracranial hemorrhage, hypoxic-ischemic encephalopathy, etc; Postpartum causes are mostly infection, such as neonatal sepsis, intracranial infection, bilirubin encephalopathy, etc.

Zhang Xiufang said that some pregnant women have high risk factors for reproductive cerebral palsy. "For example, if a pregnant woman needs to be protected for many times, her mother has cardiorespiratory symptoms, malnutrition, frequent exposure to radiation, hypertension during pregnancy and other complications, which are likely to affect the brain development of the fetus, there is a high risk of cerebral palsy."

Treatment of cerebral palsy, ranging from thousands to tens of thousands every month

There are four manifestations of cerebral palsy: abnormal movement, posture, muscle tension, and nerve reflex. For example, if you walk late, you always stand up with tiptoe landing, scissors step, wind, delay in speaking or ambiguity, often accompanied by intellectual impairment, these are the early symptoms of cerebral palsy. However, to diagnose whether a child has cerebral palsy, we should not only rely on these symptoms, but also ask the mother whether there are any high-risk factors during pregnancy and childbirth.

In addition, relevant inspections are also required. Zhang Xiufang said that whether children's brain development is abnormal can be found through MRI and EEG. "If parents find that children have early symptoms of cerebral palsy, they must go to the hospital as soon as possible for diagnosis and treatment so as to intervene as soon as possible."

"Although the recovery effect of cerebral palsy is not ideal, active treatment still has a certain effect. Even if they can't catch up with normal children, they will also make more progress and become better and better than themselves." Zhang Xiufang further said that some children with cerebral palsy have no mental abnormalities, or the degree of mental abnormalities is low, and they still hope to live independently in the future.

"The hospital has formed a systematic management system for high-risk infants, with regular follow-up, detection and evaluation, so as to realize early detection and intervention of cerebral palsy infants." Hao Suyuan explained that 0-3 years old is the key period for infants' brain development, and 0-1 years old is the most important period. At this time, brain function has certain plasticity and variability, Early intervention in time can reduce the risk of cerebral palsy and improve the prognosis.

For cerebral palsy, the current treatment methods mainly include medication, surgery and rehabilitation training, especially the latter. "Drugs are mainly used to nourish the nerves, such as vitamin B12 and vitamin B1, which can nourish nerve factors and have a certain effect." Zhang Xiufang said, "The operation is aimed at some children with cerebral palsy, such as spastic cerebral palsy, but it can only improve the children's sports condition, and cannot be completely cured."

Rehabilitative training is a kind of treatment in many hospitals and rehabilitation institutions, including physical training, skill training, language training, etc. "After the arrival of the child, we will first conduct a neuromotor behavior assessment, including sports, cognitive language, social behavior, living ability, hand function, etc., then judge the development stage of the disease, and develop different rehabilitation training plans according to the specific situation of each child. Physical rehabilitation training is the most effective intervention measure. What needs to be emphasized is the management of high-risk infants, and the family centered treatment and education combination model has important practical significance. " Hao Suyuan said.

Although there is a glimmer of hope, many families still choose to give up. A very important reason is the huge economic pressure. "It costs a lot to treat children with cerebral palsy. If you insist on rehabilitation training in hospitals, plus some drug treatment, it will cost thousands or tens of thousands a month." Zhang Xiufang suggested that if the family's economic conditions are not good, parents can learn some rehabilitation training methods to help children train at home.

(At the request of the interviewee, the children and parents in this topic are pseudonyms)

Early symptoms of children with cerebral palsy

During the neonatal period, the whole body is hard and soft, the spontaneous movement is reduced, the lactation is difficult, the crying is weak, easy to straighten up, easy to startle;

In February, there is no smile, but continuous crying;

In March, no laughing and no looking up;

April Thumb adduction and fist holding;

In May, there was no babbling sound of communication, unable to reach for objects, and slow reaction;

In June, he won't roll over, his hands, mouth and eyes are uncoordinated, and his name doesn't respond.