Abstract
The aim of this long-term longitudinal study in Taiwan was to estimate and compare the prevalence of cerebral palsy (CP) and to identify the age of CP diagnosis of term-born and preterm children with different birthweights. Records of 1494 extremely low birth weight (ELBW, <1000 g), 3961 very low birth weight (VLBW, 1000–1499 g), 19,612 low birth weight (LBW, 1500–2499 g) preterm, and 100,268 matched term-born children were retrieved from Taiwan′s National Health Insurance Research Database. According to a 12-year retrospective data review, the results showed the highest prevalence of CP in preterm ELBW children (147.3 cases per 1000 neonatal survivors), followed by preterm VLBW (97.2 cases), preterm LBW (27.7 cases), with the lowest prevalence in term-born children (2.5 cases). Regardless of the birthweight group, 90% of preterm children with CP were diagnosed by 4 years of age, but it was 7 years before 90% of term-born children with CP were diagnosed. After removing the children whose CP was caused by brain infections, injuries, or cerebrovascular accidents after 4 months of age, there were similar mean ages at the initial CP diagnosis (1.58–1.64 years of age) across birthweight groups born prematurely, but initial diagnosis occurred at an older age (2.41 years of age) in term-born children. The results indicate that birthweight is reversely correlated with the prevalence of CP in preterm children. Although the three preterm birthweight groups received different types of developmental follow-up programs after birth, it did not influence their age at the initial diagnosis of CP. Furthermore, we suggest that follow-up for at least 4 years after birth for preterm children, and 7 years for term-born children, is optimal for estimating CP prevalence. In order to identify and provide early intervention for term-born children with CP earlier, it is suggested that parents routinely fill out a self-reported motor developmental screening questionnaire and pediatricians conduct a motor developmental examination on term-born children at each time of scheduled vaccination injections.
Highlights
Cerebral palsy (CP) describes a group of disorders characterized by movement and postural problems, which are attributed to non-progressive injuries in the developing brain [1]
Birth weight; LBW: low birth weight. In this national- and population-based study, we retrospectively investigated the. In this national- and population-based study, we retrospectively investigated the prevalence of CP and the age of first diagnosis of CP for term and preterm children from prevalence of CP and the age of first diagnosis of CP for term and preterm children from birth to 12 years old
The results of this study indicate that the prevalence of CP in Taiwanese children born prematurely and at term were higher than that reported in developed Western countries, which may be attributed to methodological differences
Summary
Cerebral palsy (CP) describes a group of disorders characterized by movement and postural problems, which are attributed to non-progressive injuries in the developing brain [1]. The most common cause of the preterm population being at a high risk of CP is a white matter injury (e.g., periventricular hemorrhage and periventricular leukomalacia) during the perinatal period [3,4]. The main causes of CP for those born at term are thrombophilic disorders (e.g., cerebral infarction related to perinatal or intrauterine thromboembolism) [4,5], kernicterus, perinatal hypoxic-ischemic event, TORCH infection, brain malformations, and perinatal ischemic strokes [6,7]. A large number of studies have investigated the prevalence of cerebral palsy in preterm populations, most of them are based on the data of Western countries, including various European countries, Canada, Australia, and the United States of America [8]. Similar studies on preterm children in Asian countries are relatively fewer and with smaller sample sizes [9], except for one Korean population-based nationwide study, which investigated the rate of preterm birth in children with CP [10]
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