Declining prevalence of cerebral palsy in children born at term in Denmark

Abstract

Aim To investigate reasons for the declining prevalence of cerebral palsy (CP) in children born at term in Denmark by evaluating obstetric and neonatal factors associated with CP, and their changes over time. Method In this cohort study, we included 987 495 children (504 600 [51.1%] males and 482 895 [48.9%] females) born after 37 completed gestational weeks during birth years 1997 to 2013. Risk ratios of CP for each factor were calculated with log‐binominal regression analyses. Significant factors were evaluated concerning their development in prevalence over time. Results In the antenatal period, there were significant associations with an increased risk of CP and high maternal body mass index (BMI), smoking during pregnancy, nulliparity, male sex, gestational age, and low birthweight. In the study period, fewer females smoked during pregnancy and fewer children were born post‐term, dropping from 22.6% to 11.4% and 9.4% to 2.5% respectively. Conversely, the proportion of females with high BMI increased. Most significant risk factors were found in the neonatal period, with an increase in children with diagnosed birth defects and children admitted to neonatal care. Interpretation Reasons for the declining prevalence of CP appear to be multifactorial and likely include the decline in maternal smoking and children born post‐term along with centralization and advances in neonatal treatment.

Development of a Bedside Tool to Predict the Diagnosis of Cerebral Palsy in Term-Born Neonates

“…Only variables that were consistently defined between databases were considered. Selection of specific variables was based on the literature …”

The effects of cerebral oximetry in mechanically ventilated newborns: a protocol for the SafeBoosC-IIIv randomised clinical trial

“…A metaanalysis including 895 neonates from 23 retrospective and prospective observational studies undergoing surgery for non-cardiac congenital anomalies, found a de cit in intelligence quotient of 0.5 standard deviations (approximately 5-7 IQ points) below the population average (6). Additionally, data from a Danish national cohort showed that 18% of children who underwent mechanical ventilation during the neonatal period needed special educational support in primary school, which is 2.5 times more often than normal (Wiingreen et al, unpublished data) and the risk of cerebral palsy increased 4-fold, after adjustment for other risks (7). Thus, mechanically ventilated newborns are a high-risk population.…”

The effects of cerebral oximetry in mechanically ventilated newborns: a protocol for the SafeBoosC-IIIv randomised clinical trial

“…A meta-analysis including 895 neonates from 23 retrospective and prospective observational studies undergoing surgery for non-cardiac congenital anomalies found a deficit in intelligence quotient of 0.5 standard deviations (approximately 5 to 7 IQ points) below the population average [ 6 ] (although this result is confounded by the risks associated with surgery in itself and those of the underlying conditions). Additionally, data from a Danish national cohort showed that 18% of children who underwent mechanical ventilation during the neonatal period needed special educational support in primary school, which is 2.5 times more often than normal (Wiingreen et al, unpublished data) and the risk of cerebral palsy increased fourfold, after adjustment for other risks [ 7 ].…”