Abstract
OBJECTIVESTo report epidemiological trends in cerebral palsy including analyses by severity.DESIGNDescriptive longitudinal study in north-east England. Every child with suspected cerebral palsy was examined by a developmental paediatrician to confirm...
Highlights
For the more reliably ascertained cases with severity exceeding 30%, there was a twofold increase in rate from 0.98 to 1.96
Modern obstetric and neonatal care is associated with a substantial increase in the overall rate of cerebral palsy due mainly to the increases in the rate of cerebral palsy in those < 2500 g
Many newborns < 2500 g who would have died survive with cerebral palsy, which is no less severe than it used to be and is more severe than that in normal birth weight babies
Summary
To report epidemiological trends in cerebral palsy including analyses by severity. Severity of 30% and above defines the more reliably ascertained cases; children who died before assessment at around 6 years of age are included in the most severe group (70% and above). Results—584 cases of cerebral palsy were ascertained, yielding a rate that rose from 1.68 per 1000 neonatal survivors during 1964–1968 to 2.45 during 1989–1993 (rise = 0.77; 95% confidence interval 0.2– 1.3). For the more reliably ascertained cases there was a twofold increase in rate from 0.98 to 1.96 (rise = 0.98; 95% confidence interval 0.5–1.4). Conclusions—The rate of cerebral palsy has risen in spite of falling perinatal and neonatal mortality rates, a rise that is even more pronounced when the mildest and least reliably ascertained are excluded. A global measure of severity should be included in registers of cerebral palsy to determine a minimum threshold for international comparisons of rates, and to monitor changes in the distribution of severity
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Schedule a callMore From: Archives of Disease in Childhood - Fetal and Neonatal Edition
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