Congenital anomalies in children with cerebral palsy: a population‐based record linkage study

Abstract

AIM Our aim was to determine the proportion of children with cerebral palsy (CP) who have a congenital anomaly (CA) in three regions (Isè re Region, French Alps; Funen County, Denmark; Northern Region, England) where population-based CP and CA registries exist, and to classify the children according to CA subtype.METHOD Data for children born between 1991 and 1999 were linked using electronic matching of cases. All potential matches were checked manually by each centre and verified as true matches.RESULTS A total of 1104 children with CP were born during the study period (663 males, 441 females). Of these, 166 (15%; 95% Confidence Interval [CI] 13.0-17.3) children with CP had a CA: 8.8% had a cerebral anomaly, 4.8% had a non-cerebral anomaly, and 1.4% had a non-cerebralrelated syndrome or a chromosomal ⁄ genetic anomaly.INTERPRETATION The prevalence of cerebral anomaly was highest in children with ataxic CP (41.7%) and lowest in those with dyskinetic CP (2.1%). Cerebral anomalies were found in 8.4% and 7% of children with bilateral and unilateral spastic CP respectively. The most frequent cerebral anomalies were primary microcephaly (26.5%) and congenital hydrocephalus (17.3%). The most common non-cerebral anomalies recorded were cardiac (12.6% of children with CP and CA), urinary (5.4%), and musculoskeletal (5.4%). The prevalence of cerebral anomalies was higher among children born at term (13%) than among those born preterm (3.8%). Associated sensorineural or intellectual impairments occurred more often in children with CP and cerebral anomalies. We concluded that cerebral and non-cerebral CA prevalence was higher among the CP population than in the general population of live births.

Congenital malformations and the cerebral palsies – déjà vu, but now what?

“…It is, therefore, the more convincing that the same conclusions have been reached by Rankin et al 4 This work has taken further the investigation reported by Garne and European collaborators in 2008. 5 This simply compared the prevalence of congenital malformations reported in a number of high quality and standardized CP registers with that estimated using local population-based congenital malformation registers.…”

“…5 This simply compared the prevalence of congenital malformations reported in a number of high quality and standardized CP registers with that estimated using local population-based congenital malformation registers. Rankin et al 4 linked cases in three CP registers with those in local congenital malformation registers, thus obtaining more clinical information on the matched children. As in the much earlier literature, the excess of congenital malformations in the cerebral palsies was found particularly in children with spastic types of CP rather than dystonia or athetosis, and in those who were term births.…”

“…While this is not the first study of hand development in children with CP, [3][4][5] this is the first study of bimanual hand use using a standardized measure. The findings of the AHA differ from those of the Manual Ability Classification System in the same children, which is in line with the other developmental studies to date indicating that various aspects of hand development progress with different time courses and rates.…”

Congenital non‐central nervous system malformations in cerebral palsy: a distinct subset?

“…[18][19][20][21] A study based on the CP Register and the Birth Defect Registry of Western Australia reported that 15.8% of children with CP had non-CNS anomalies. 19 Pharaoh 21 demonstrated an increase in eye anomalies, cardiac anomalies, cleft lip and ⁄ or palate, congenital dislocation of the hip and talipes, and atresias of the oesophagus and intestines in children with CP.…”

Treating an intervention level 1 patient: futile or brave?

“…[4][5][6][7][8][9] It has been documented that CP occurs in 2-2.5/1 000 live births. 10 Causes of CP include being born before term, not receiving enough oxygen during the birth, the foetus being exposed to maternal infection and/or inflammation in utero, and maternal fever during labour.…”