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EARLY HAND PREFERENCE AND THE RISK FOR CEREBRAL PALSY

Hand preference is generally not acquired in infants until approximately 2 years of age. Eleven graduates from the intensive care nursery undergoing developmental evaluations at 6 months corrected age were either reported by parents or detected on motor exam to have hand preference. Mean birth weight was 1492 grams (range=700-3500 grams) and gestational age 30.8 weeks (range=26-40 weeks). Diagnoses included respiratory distress syndrome (10) and group B streptococcal meningitis (1). Only 1 infant with respiratory distress syndrome had a significant intracranial bleed with subsequent post-hemorrhagic hydrocephalus necessitating ventriculo-peritoneal shunt placement.By 12 months corrected age, 8 of the 11 infants (73%) continued to demonstrate hand preference, including the infants with group B streptococcal meningitis and post-hemorrhagic hydrocephalus. All 8 have subsequently been diagnosed with cerebral palsy (CP), with the remaining 3 exhibiting normal development. We conclude that persistent hand preference within the first year of life may be an early predictor of cerebral palsy as a developmental outcome.