- 31st European Academy of Childhood Disability 2019 Conference, 23 a 25 de Maio de 2019.
Introduction. TORCH infections are a cause of severe disorders in the foetus and newborn and may be associated to cerebral palsy (CP). Their importance was evaluated concerning aetiology, clinical presentation and function in children in CP.
Patients and methods. The National Portuguese Surveillance of Cerebral Palsy at five years of age (NPSCP5YA) registers children with PC born since 2001. The definition and classification of Surveillance of Cerebral Palsy in Europe (SCPE) are used. Clinical and functional characterization and risk factors for CP was carried out in children born 2001-2010 comparing cases with TORCH infection (definition TORCHnet) with the remainder.
Results. 70 cases out of 1193 (6%) were identified: CMV 44, HIV 13, syphilis 6 and CMV+VIH 2. Bilateral spastic CP predominated (71% vs 53%). Functional impairment is significantly more severe (GMFCS, BMFM, cognition and Viking Speech Scale), comorbidities more frequent (epilepsy, severe neurossensorial handicap). The MRI shows a greater percentage of brain malformations (40% vs 12%) and more miscellaneous cases (33% vs 10%) with rare cases of normal MRI (2,5% vs 5,7%). PC associated with TORCH infection is significantly associated with term/near term delivery, mother's age < 20yo, small for gestational age (SGA), Apgar score < 6, less seizures in first 72 hours and less admissions in Neonatal Units.
Conclusions. TORCH infections are relatively frequent in children with CP. Although neonatal presentation appears to be less severe is increased at 5 years of age. It is recommended to look for TORCH infection in children with CP or high suspicion of CP without known risk factors, born at term or near term, SGA, in young mothers and with encephalous malformations.