Trends in cerebral palsy among infants of very low birth weight (<1500 g) or born prematurely (<32 weeks) in 16 European centres: a database study

Abstract

. Platt M. J., Cans C., Johnson A., Surman G., Topp M., Torrioli M. G. & Krageloh‐Mann I. ( 2007 ) , 369 , 43 – 50 . Background The risk of cerebral palsy, the commonest physical disability of children in western Europe, is higher in infants of very low birth weight (VLBW) – those born weighing less than 1500 g – and those from multiple pregnancies than in infants of normal birth weight. An increasing proportion of infants from both of these groups survive into childhood. This paper describes changes in the frequency and distribution of cerebral palsy by sex and neurological sub‐type in infants with a birth weight below 1000 g and from 1000 to1499 g in the period 1980–1996.Methods A group of 16 European centres, Surveillance of Cerebral Palsy in Europe, agreed on a standard definition of cerebral palsy and an inclusion and exclusion criteria. Data for children with cerebral palsy born in the years 1980–1996 were pooled. The data were analysed to describe the distribution and prevalence of cerebral palsy in VLBW infants. Prevalence trends were expressed as both per 1000 live births and per 1000 neonatal survivors.Findings There were 1575 VLBW infants born with cerebral palsy; 414 (26%) were of birth weight less than 1000 g, and 317 (20%) were from multiple pregnancies. One thousand four hundred twenty‐six (94%) had spastic cerebral palsy, which was unilateral (hemiplegic) in 336 (24%). The birth prevalence fell from 60.6 (99% CI 37.8–91.4) per 1000 liveborn VLBW infants in 1980 to 39.5 (28.6–53.0) per 1000 VLBW infants in 1996. This decline was related to a reduction in the frequency of bilateral spastic cerebral palsy among infants of birth weight 1000–1499 g. The frequency of cerebral palsy was higher in male than in female babies in the group of birth weight 1000–1499 g [61.0 (53.8–68.2) vs. 49.5 (42.8–56.2) per 1000 live births; P = 0·0025], but not in the group of birth weight below 1000 g.Interpretation These data from a large population base provide evidence that the prevalence of cerebral palsy in children of birth weight less than 1500 g has fallen, which has important implications for parents, health services and society.