1 Division of Neurology British Columbia Children's Hospital Vancouver, British Columbia, Canada
2 Division of Neonatology Department of Pediatrics University of British Columbia Vancouver, British Columbia, Canada
The comments of Dr Badawi et al draw attention to some of the ambiguities in the current understanding of potential significant factors associated with peninatal hypoxic-ischemic cerebral injury. Experimental animal data has demonstrated clearly that intrapartum hypoxic-ischemic insult may result in cerebral injury.1,2 However, epidemiologic studies have raised concerns that this relationship may not be as prevalent as was believed earlier.3-5 Nevertheless, it is important to consider that even if only 10% to 15% of cases of cerebral palsy are related to intrapartum hypoxic-ischemic cerebral injury, this would still constitute significantly large numbers in absolute terms.