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Motor disability in children in three birth cohorts
C Rumeau-Rouquette1, C du Mazaubrun, A Mlika
1Unité 149 de l'INSERM, Paris, France.
Insights
Motor disability (MD) prevalence remained stable across French birth cohorts (1972-1981), despite declining preterm birth rates. Cerebral palsy (CP) rates were consistent, but hereditary central nervous system (CNS) diseases increased in the latest cohort.
Area of Science:
- Pediatrics
- Neurology
- Public Health Epidemiology
Background:
- Decreasing preterm birth rates and neonatal mortality in France suggested potential shifts in motor disability (MD) prevalence.
- Evolving perinatal practices necessitated an evaluation of their impact on childhood neurological and motor development.
- Previous French perinatal surveys indicated significant changes in obstetric and neonatal care during the study period.
Purpose of the Study:
- To assess changes in the prevalence of motor disability (MD) components across three French birth cohorts (1972, 1976, 1981).
- To investigate the impact of evolving perinatal practices on the incidence of specific types of motor disabilities.
- To compare the prevalence of cerebral palsy (CP) and other motor disabilities between different birth years.
Main Methods:
- A systematic registration of motor disabilities (MD) was conducted in 14 French departments during 1985-1986 and 1989.
- Data included 1355 registered MD cases among children born in 1972, 1976, and 1981.
- Prevalence rates were calculated per 1000 live births for different MD etiologies and compared across cohorts.
Main Results:
- Overall MD prevalence was 3.34 per 1000 births, showing no significant change across the three cohorts.
- Cerebral palsy (CP) prevalence remained stable (1.30, 1.06, 1.08 per 1000 for 1972, 1976, 1981 cohorts, respectively).
- An increased prevalence of hereditary and degenerative central nervous system (CNS) diseases was observed in the 1981 birth cohort.
Conclusions:
- Despite improvements in perinatal care and reduced infant mortality, the overall prevalence of motor disability (MD) remained stable.
- Cerebral palsy (CP) rates were unaffected by changes in perinatal practices during this period.
- The rise in hereditary/degenerative CNS diseases warrants further investigation into potential genetic or environmental factors.
Abstract:
A systematic registration was carried out in 1985-1986 and 1989 in 14 French 'departments' in order to assess whether the prevalence rates of different components of motor disability (MD) in three different birth cohorts (1972, 1976 and 1981) had changed at a time when the preterm birth rate and neonatal mortality were decreasing and there was evidence of changing perinatal practice. A total of 1355 MD were registered amongst resident children born in 1972, 1976 and 1981 with a prevalence of 3.34 per 1000. The prevalence of the MD types due to different causes did not differ significantly amongst the three birth cohorts with the exception of an excess of hereditary and degenerative disease of the central nervous system (CNS) among children born in 1981. The prevalence of cerebral palsy (CP) remained stable in the three birth cohorts: it was 1.30, 1.06 and 1.08 per 1000 respectively, for children born in 1972, 1976 and 1981. The prevalence of pre- or perinatal-origin of other motor disabilities (OMD) and of CNS malformations did not differ amongst the three birth cohorts. The method of registration is discussed and the results are related to those of the French perinatal surveys performed in 1972, 1976 and 1981, which showed a decrease in preterm birthrate, an increase in perinatal care and a decrease in the mortality rate of high-risk infants.