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Published on: January 11, 2016
Trends in the prevalence of cerebral palsy in a population-based study
Sarah Winter1, Andrew Autry, Coleen Boyle
1Department of Pediatrics, Emory University, Atlanta, Georgia, USA. swinter@chi.osu.edu
Insights
The prevalence of cerebral palsy (CP) in 1-year survivors increased slightly from 1975-1991, primarily in infants with normal birth weight. Rates for low birth weight infants remained stable during this period.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Congenital cerebral palsy (CP) is a leading cause of childhood disability.
- Understanding trends in CP prevalence is crucial for public health initiatives and resource allocation.
Purpose of the Study:
- To examine trends in the prevalence of congenital cerebral palsy (CP) over a 16-year period.
- To analyze these trends in 1-year survivors using a population-based surveillance program.
Main Methods:
- Utilized a 5-county metropolitan Atlanta surveillance program for children with CP.
- Analyzed data from 1975-1977, 1981-1985, and 1986-1991 birth cohorts.
- Examined trends by birth weight, race, CP subtypes, and co-occurring disabilities.
Main Results:
- Overall CP prevalence in 1-year survivors rose modestly from 1.7 to 2.0 per 1000.
- The increase was driven by a rise in CP among normal birth weight infants.
- CP prevalence in low and very low birth weight infants showed no consistent trends.
Conclusions:
- A modest increase in congenital CP prevalence was observed in 1-year survivors from 1975-1991.
- This increase was specific to infants with normal birth weight.
- Trends in CP prevalence for low and very low birth weight infants did not change significantly.
Objective:
To determine trends in the prevalence of congenital cerebral palsy (CP) over a 16-year period for 1-year survivors using a large, population-based surveillance program.
Methods:
We determined birth weight-specific trends in the prevalence of CP in live birth and 1-year survivor cohorts of children in a 5-county metropolitan Atlanta area for the periods from 1975-1977, 1981-1985, and 1986-1991. We ascertained children with CP in metropolitan Atlanta by record review as part of an ongoing developmental disability surveillance program conducted by the Centers for Disease Control and Prevention and the Georgia Department of Human Resources. A total of 110, 262, and 443 cases of congenital CP were identified for the birth years 1975-1977, 1981-1985, and 1986-1991, respectively. Data were analyzed by birth weight, race, subtypes of CP, and whether the CP existed as an isolated disability or was accompanied by another disability.
Results:
There was a modest increase in the overall prevalence of congenital CP from 1.7 to 2.0 per 1000 1-year survivors during the period from 1975-1991. This trend was primarily attributable to a slight increase in CP in infants of normal birth weight--CP rates in moderately low and very low birth weight infants did not show consistent trends. There was an increase in the proportion of children who had CP and no other disabilities that was most apparent in infants of normal birth weight from 17% in 1975-1977 to 39% in 1986-1991. For children weighing <1500 g, the proportion of children with spastic diplegic CP increased over time (7% of cases in 1975-1977, 36% in 1985-1988, and 32% in 1986-1991).
Conclusions:
In the only ongoing population-based study of CP in the United States, there has been a modest increase in the prevalence of CP in 1-year survivors born from 1975-1991. This increase however was seen only in infant survivors of normal birth weight. No change was seen in the trends in CP prevalence in low birth weight and very low birth weight infant based on infant survivors.
