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Education And Debate

A template for defining a causal relation between acute intrapartum events and cerebral palsy: international consensus statement

BMJ 1999; 319 doi: (Published 16 October 1999) Cite this as: BMJ 1999;319:1054
  1. Alastair MacLennan, associate professor, for the International Cerebral Palsy Task Force* (
  1. Department of Obstetrics and Gynaecology, University of Adelaide Women's and Children's Hospital, North Adelaide, South Australia 5006, Australia

    Chairman's foreword

    In 1997 the research committee of the Perinatal Society of Australia and New Zealand competitively funded a special initiative to bring together the modern literature on the causation of cerebral palsy, and to try to define an objective template of evidence to better identify cases of cerebral palsy where the neuropathology began or became established around labour and birth. Recently there have been many advances in a wide variety of scientific areas associated with cerebral palsy, and thus this multidisciplinary review may benefit research into the causation and prevention of cerebral palsy and may also help those who offer expert opinion when counselling in this area or giving such opinion in court.

    The corresponding task force was open to anyone who could make a scientific contribution to understanding in this area. The task force had representation from a wide range of clinical and scientific specialties. Submissions were sought from the society's 1000 members, which include scientists, pathologists, obstetricians, neonatalogists, midwives, neonatal nurses, and epidemiologists. International contributions were sought from those identified from the current literature as contributing to this area through peer reviewed research. They were not preselected for their views, and they were invited to join the corresponding task force Some international members joined later in the discussion process as word of this open debate reached them.

    During 1997 and 1998 multiple online electronic conferences were held, and in March 1998 many of the task force members were able to participate in a workshop in Alice Springs, Australia to discuss the fourth draft of the statement. Drafts of the statement were circulated and debated, with the sixth draft being discussed at an international telephone conference in October 1998. The paper continued to be redrafted eight times until consensus was reached. No opinion was excluded from the debate, but the …

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