Multiple birth and cerebral palsy in Europe: a multicenter study

Area of Science:

• Neurology
• Pediatrics
• Public Health

Background:

• The Surveillance of Cerebral Palsy in Europe (SCPE) study investigated trends in multiple births and their association with cerebral palsy (CP).
• The study aimed to compare CP rates and clinical types between multiple births and singletons.
• It also analyzed the impact of birth order on CP risk in twins.

Purpose of the Study:

• To describe temporal changes in multiple birth rates and cerebral palsy (CP) rates among multiple-born infants.
• To compare CP rates and clinical types between multiples and singletons.
• To analyze the influence of birth order on CP risk in twins.

Main Methods:

• Data were collected from 12 European population-based CP registers, encompassing 6613 children born between 1975 and 1990.
• Demographic data were analyzed alongside CP registry information.

Main Results:

• Multiple birth rates increased from 1.9% to 2.4% between 1980 and 1990; the proportion of multiples among CP infants rose from 4.6% to 10% during the same period.
• Multiples exhibited a fourfold higher rate of CP compared to singletons (7.6 vs. 1.8 per 1000 live births).
• CP risk in multiples was marginally higher for those with birthweight > 2500g and born at term, with no significant difference in low-birthweight or preterm groups. Second-born twins had a higher CP incidence than first-born twins.

Conclusions:

• Multiple-born infants face a four times greater risk of developing cerebral palsy, primarily due to the increased likelihood of preterm birth.
• The doubling of multiple births throughout the 1980s correlated with a rise in cerebral palsy cases among this population.