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The incidence of cerebral palsy
1Department of Obstetrics and Gynecology, Sloane Hospital for Women of Columbia Presbyterian Medical Center, New York, New York.
Insights
Cerebral palsy (CP) affects 2.7 per 1000 births, with 36% in infants under 2500 grams. Intrapartum-related CP risk is low, around 1 in 2000 term births, suggesting other causes are more common.
Area of Science:
- Neurology
- Pediatrics
- Obstetrics
Background:
- Clinicians face responsibility for obstetric events linked to cerebral palsy (CP).
- Understanding CP incidence is crucial for clinical assessment and medicolegal situations.
- Published studies are reviewed to clarify CP rates and associations.
Purpose of the Study:
- To determine the incidence of cerebral palsy.
- To calculate CP rates across different birth weights.
- To assess the co-occurrence of CP with serious mental retardation.
Main Methods:
- A comprehensive search of published studies was conducted.
- Composite incidence rates of CP were calculated.
- Rates were analyzed based on birth weight and presence of mental retardation.
Main Results:
- The cumulative incidence of CP was 2.7 cases per 1000 births by age 5-7 years.
- Infants weighing less than 2500 grams accounted for approximately 36% of all CP cases.
- Serious mental retardation (IQ < 50) accompanied CP in 30% of term infants and 18% of infants < 2500 grams.
Conclusions:
- Given that 70% of CP is antepartum or of unknown origin, the risk of intrapartum-attributed CP in term infants is estimated at 1 in 2000.
- This suggests a low likelihood of intrapartum events being the sole cause of CP in term infants.
- Findings aid clinicians in evaluating obstetric events suspected of causing cerebral palsy.
Abstract:
The clinician is often held responsible for obstetric events that are suspected of being related to cerebral palsy. To review the incidence of cerebral palsy and to aid the clinician in this situation, a search of published studies was conducted. Composite rates of cerebral palsy in different birth weight infants and cerebral palsy with and without serious mental retardation were calculated. The cumulative incidence rate at the age of 5 to 7 years was 2.7 cases of cerebral palsy for 1000 birth cohorts. Approximately 36% of all cerebral palsy occurred in the infant less than 2500 gm. Serious mental retardation (intelligence quotient less than 50) accompanied cerebral palsy approximately 30% of the time for the term infant and 18% of the time when the infant was less than 2500 gm. On the basis of a past estimation that 70% of cerebral palsy is of antepartum or unknown origin, the term infant at risk for intrapartum-attributed cerebral palsy may be about 1 in 2000 term births.