Newborns' Stroke Risk as High as Elderly's

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Newborns' Stroke Risk as High as Elderly's

 

 

By Janice Billingsley, HealthDay Reporter

 

MONDAY, July 11 (HealthDay News) -- Strokes are

usually associated with older adults, but a new study

finds their incidence among newborns is equal to that

of the elderly.

 

In most cases, infant stroke means long-term

neurological problems for those babies who suffer

them, researchers add.

 

" We don't think of babies as having a high risk of

stroke, but strokes do occur in babies and cause

significant lifelong disabilities, " said co-researcher

and child neurologist Dr. Donna M. Ferriero, professor

of neurology and pediatrics at the University of

California, San Francisco (UCSF).

 

Examining records of nearly 200,000 children born in

northern California over a five-year period, the

researchers found that approximately one out of 5,000

infants had strokes near birth -- a rate that equals

that of elderly people, according to Ferriero.

 

Furthermore, nearly 80 percent of the infant strokes

caused long-term neurological problems for the

children, including cerebral palsy, epilepsy, language

problems and hyperactivity.

 

By raising awareness of the frequency of stroke in

newborns, Ferriero hopes that parents and doctors will

begin to pay closer attention to the sometimes subtle

signs of strokes in young children and commence

brain-saving therapies as soon as possible.

 

" Disabilities can be altered by appropriate early

recognition and attention. Early intervention does

matter, " she said. " The brain is plastic and can adapt

to physical and occupational therapy. "

 

In the study, the UCSF team examined the medical

records of more than 199,000 children born between

1997 and 2002 to families enrolled in the Northern

California Kaiser Permanente Medical Care Program.

 

They found the overall rate of strokes occurring

either during labor and delivery or in the month after

birth (perinatal strokes) was about one in 5,000

births. However, the study authors believe actual

rates are even higher since strokes must be confirmed

by brain imaging -- not always used on children with

more subtle neurologic symptoms.

 

Post-stroke disability was common: 58 percent of

children were diagnosed with cerebral palsy, a

neurologic disorder characterized by muscle weakness;

39 percent had epilepsy; 25 percent were reported to

have delays in language; and 22 percent displayed

behavioral abnormalities such as hyperactivity.

 

Cerebral palsy was more likely to occur in infants

without initial symptoms, the researchers reported. In

those cases, no evidence of stroke was found until

months after birth when the child was discovered to

have a diminished use of one hand, for example.

 

Ferreiro said that further research is needed to

understand the cause of these strokes, for which there

is presently no treatment. A previous UCSF study found

that babies born to women with a history of

infertility, women who had infections in the membranes

of the uterus during pregnancy, or women experiencing

a delivery-linked blood pressure condition called

preeclampsia were all at higher risk of perinatal

stroke.

 

The results of the study, funded in part by the United

Cerebral Palsy Foundation, appear in the July 11

Annals of Neurology.

 

Dr. John Kylan Lynch, a researcher at the National

Institutes of Health, said this study is important

because it's both large and based on data taken from

the general population rather than from studies

looking only at stroke victims. Furthermore, it

included cases where the symptoms of stroke appeared

later on, after a child was taken home from the

hospital.

 

" It's important for the public to know that most

children [with strokes] will present with seizures in

the hospital, but that some will look normal until

about two months of age, when they will develop

difficulty with motor movements on one side of the

body, " he said.

 

Ferreiro said that the best thing parents can do is

trust their instincts if they think their child is

having development problems.

 

" In the nursery, nurses are very good at picking up

[on strokes], but once babies go home it's up to the

parents, " she said. " Parents are the best observers of

their children's skill sets, and if a parent is not

comfortable with his or her child's cognitive or motor

development, she should trust her judgment. "

 

Parents should talk to their child's pediatrician and

not hesitate to ask for a referral to a specialist,

she recommended. They should also look for signs of

stroke -- for example, if the child is only using one

arm or seems to have visual recognition or attention

problems, she added.

 

 

SOURCES: Donna M. Ferriero, M.D. professor, neurology

and pediatrics, University of California, San

Francisco; John Kylan Lynch, D.O., M.P.H., National

Institute of Neurological Disorders and Stroke,

National Institutes of Health, Bethesda, Md.; July 11,

2005, Annals of Neurology

 

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