Cerebral palsy: social class differences in prevalence in relation to birthweight and severity of disability.

Dowding, V. M.; Barry, Catherine

doi:10.1136/jech.44.3.191

Cited by 49 publications

(64 citation statements)

References 7 publications

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“…Multiple birth is one changing risk factor, increasing during the study period because of increasing maternal age and use of assisted conception, but multiple births at low gestational age are not at a substantially greater or lower risk of CP than singletons of the same gestational age (Topp et al 2004). Previous studies have found no socioeconomic gradient for CP among low birthweight births (Dowding andBarry 1990, Dolk et al 2001), so it is unlikely that socioeconomicallyrelated risk factors, such as maternal smoking, have a strong positive or negative association with risk of CP, independent of their effect on birthweight.…”

Section: Discussionmentioning

confidence: 95%

“…Aetiology of most cases is unclear, although observations of socioeconomic gradients in prevalence (Dowding andBarry 1990, Dolk et al 2001) suggest environmental factors may be important. Magnetic resonance imaging studies indicate that of individuals with CP born at term, the aetiology of CP may be of late third trimester origin in a third, of early third trimester origin in a third, and of earlier or genetic origin associated with brain malformations in another third (Krageloh-Mann 2000) of those affected.…”

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confidence: 99%

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Trends in the prevalence of cerebral palsy in Northern Ireland, 1981-1997

Dolk

Parkes

Hill³

2007

Developmental Medicine &Amp; Child Neurology

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We describe trends in the prevalence of cerebral palsy (CP) by birth weight group, and in the severity of motor impairments and presence of associated intellectual impairment, in Northern Ireland from 1981 to 1997 (n=909; 510 males, 399 females; total population 415 936 live births) using data from a population‐based register of CP. Children with suspected CP or who died before 1 year of age and those with CP of postneonatal origin were excluded. Prevalence of CP was 2.2 per 1000 live births without significant change over time. Among very‐low‐birthweight (<1500g) live births, prevalence was 44.5 per 1000 (95% confidence interval 32.3–59.8) from 1994 to 1997, with evidence of a statistically significant decline in prevalence since the mid‐ to late 1980s accompanied by a decrease in the severity of motor impairment and likelihood of intellectual impairment. Among moderately‐low‐birthweight (1500–2499g) children there was weaker evidence of a peak prevalence in the late 1980s. Prevalence among normal‐birthweight infants did not change significantly, but outcome in terms of severity of motor impairment and intellectual impairment improved in the 1990s. Occurrence of bilateral spasticity from 1994 to 1997 was associated with greater severity and likelihood of intellectual impairment for normal‐birthweight individuals than for low‐ or very‐low‐birth weight individuals.

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Section: Discussionmentioning

confidence: 95%

mentioning

confidence: 99%

Trends in the prevalence of cerebral palsy in Northern Ireland, 1981-1997

Dolk

Parkes

Hill³

2007

Developmental Medicine &Amp; Child Neurology

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“…Previous studies using measures of SES based on parental occupation [13][14][15][16][17] or an area based measure of SES 18 19 have produced conflicting results (table 1). In some studies the apparent lack of an association with lower SES may be related to study methodology.…”

Section: Discussionmentioning

confidence: 99%

Cerebral palsy and socioeconomic status: a retrospective cohort study

Sundrum¹,

Logan²,

Wallace³

et al. 2005

Archives of Disease in Childhood

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Aims: To study the relation between risk of cerebral palsy and socioeconomic status. Methods: A total of 293 children with a diagnosis of cerebral palsy out of 105 760 live births between 1 January 1982 and 31 December 1997 were identified from the special conditions sub-file of the West Sussex Computerised Child Health System. Results: There was a linear association between risk of cerebral palsy and socioeconomic status (SES) measured by the Registrar General's social class (RGSC) and enumeration district (ED) ranked into quintiles by the Townsend Deprivation Index derived from 1991 census data. Fifty one per cent and 30% of cases of cerebral palsy were statistically ''attributable'' to inequality in SES using the RGSC and ED quintile respectively. A linear association was also noted for singleton live births. The association between risk of cerebral palsy and ED quintile persisted in a logistic regression model that included birth weight and gestational age, although that between RGSC and cerebral palsy no longer reached conventional levels of statistical significance after adjustment. Conclusions: A strong association was observed between socioeconomic status and the risk of cerebral palsy, which was only partly accounted for by the known social gradients in birth weight and gestational age.T he negative impact of socioeconomic deprivation has been shown for many aspects of child mortality and morbidity.1-3 The relation between socioeconomic status (SES) and the risk of cerebral palsy is not clear. An observed association between SES and cerebral palsy might suggest aetiological factors and pathways to prevention as well as being important in the planning of services and the allocation of resources.Low birth weight and prematurity are the strongest risk factors for cerebral palsy. 4 Given the observed association between these factors and SES, 5-7 an increased prevalence of cerebral palsy with low SES is expected. However, studies have produced conflicting results. Table 1 summarises the results of studies conducted in developed countries. In developing countries, there is a higher proportion of children with postnatally acquired cerebral palsy with a more clearly established socioeconomic gradient.West Sussex has a population of 750 000 with roughly 8000 births per year. Compared with national figures, fewer belong to ethnic minority groups and there is a lower rate of unemployment. However, there is a wide variation in SES with areas of deprivation. 8In the present study, population based, routinely collected data from West Sussex are used to: N Examine the relation between the prevalence of cerebral palsy and SES and between SES and the type and severity of cerebral palsy N Examine the degree to which any relation between SES and the prevalence of cerebral palsy is mediated by socioeconomic differences in birth weight and gestation.

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“…This finding corroborates the study by Halpern et al (7) , which found that children from low SES families were twice as likely to present a delay in their neurodevelopment compared to those with higher SES. A study by Dowding and Barry (28) , proved that the social class affected the most severe cases of CP.…”

Section: Discussionmentioning

confidence: 99%

Desempenho funcional de crianças com paralisia cerebral de níveis socioeconômicos alto e baixo

Assis-Madeira

Carvalho

Blascovi‐Assis

2013

Rev. paul. pediatr.

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Objective: To investigate the influence of socioeconomic status on the functional performance of children with cerebral palsy.Methods: Cross-sectional quantitative study of 49 children diagnosed with cerebral palsy from a convenience sample. Children of both genders aged three to seven and a half years were studied. They were classified according to the level of severity of cerebral palsy based on the Gross Motor Function Classification System. Participants were organized in two groups considering their high or low socioeconomic status, according to the Brazilian Economic Classification Criteria. Functional performance was assessed by the Pediatric Evaluation of Disability Inventory. The Student's t-test was applied for independent samples in order to compare means between groups.Results: Socioeconomic status did not affect functional performance of children with mild cerebral palsy. Those with moderate cerebral palsy and low socioeconomic status presented lower social function scores (p=0.027) than those with high socioeconomic status. Children with severe cerebral palsy with low socioeconomic status presented worse performance in self-care skills (p=0.021) and mobility (p=0.005). These children were more dependent regarding mobility (p=0.015) than those with high socioeconomic status.Conclusions: Socioeconomic status may influence the development process of children with cerebral palsy and must be considered as a risk factor in educational and health practices aimed at this population.

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Cerebral palsy: social class differences in prevalence in relation to birthweight and severity of disability.

Abstract: Study objective-The aim of the study was to examine the possible influence of social class on the prevalence of cerebral palsy.Design-The study was a retrospective population based survey of all cases of cerebral palsy.

Cited by 49 publications

References 7 publications

Trends in the prevalence of cerebral palsy in Northern Ireland, 1981-1997

Trends in the prevalence of cerebral palsy in Northern Ireland, 1981-1997

Cerebral palsy and socioeconomic status: a retrospective cohort study

Desempenho funcional de crianças com paralisia cerebral de níveis socioeconômicos alto e baixo

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