Children with cerebral palsy: severity and trends over time

Abstract

Increasingly, more very-low-birthweight infants in the developed world are now expected to survive the neonatal period than was previously the case. There are concerns that there may be a related increase in the number of infants developing severe sensorimotor impairments. Pooled data from five registers contributing to the UK Network of Cerebral Palsy Registers, Surveys and Databases were used to identify patterns of motor impairment in relation to additional impairments and to birthweight, and to assess whether prevalence of cerebral palsy (CP) by birthweight and by severity of motor impairment had changed over time. Low-birthweight infants are at greater risk of developing CP than larger-birthweight babies. The CP rate amongst children with birthweights <2500 g was significantly higher at 16 per 1000 livebirths [95% confidence interval (CI) 14.9, 16.2] than 1.2 per 1000 livebirths [95% CI 11, 1.2] for normal-birthweight children. Despite being at greater risk of developing CP, smaller-birthweight babies are proportionately less likely to develop the most severe forms of motor impairment. Of those born weighing > or = 2500 g, 23% compared with 15% weighing <1000 g (P < 0.001) were in the most severely motor impaired group. Severe motor impairment is associated with higher levels of additional impairments. CP rates for each motor impairment group in the 1990s were similar to those in the late 1970s. Rates of CP among infants born below normal birthweight are high but have decreased over time. The CP rate for infants weighing 1000-1499 g at birth decreased from around 180 per 1000 livebirths in 1979 to around 50 per 1000 livebirths from the early 1990s onwards.

Trends in prevalence of cerebral palsy in children born with a birthweight of 2,500 g or over in Europe from 1980 to 1998

“…[5] Less research has been carried out on the epidemiology of CP in children of NBW than in those of very low birthweight (< 1500 g). As the number and severity of impairments increase with increasing gestational age [6,7] and birthweight, [8] the type of brain lesion among term or NBW children tends to exhibit a different pattern to that of preterm or low birthweight births. [9][10][11] Time trends for CP prevalence in NBW children vary across studies.…”

Pain symptoms in patients with severe cerebral palsy: Prevalence among patients with higher degree of locomotor impairment

“…Similarly, Surman et al [18] showed that individuals with higher birth weight developed CP in the most severe form.…”

Caracterización sociodemográfica y clínica de la población atendida en el Instituto Teletón de Santiago

“…La enfermedad discapacitante más frecuente de nuestro Instituto es la PC, lo que se ajusta a la realidad mundial, pues es la principal causa única de discapacidad física en la población infantil global 20,21 . La PC constituye un síndrome y se define como una lesión o anormalidad no progresiva que se produce en un cerebro en desarrollo y que lleva a una alteración permanente en la esfera motora o del movimiento 22 .…”