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The incidence and implications of cerebral palsy following potentially avoidable obstetric complications: a

S Leigh1, P Granby, M Turner

  • 1Liverpool Health Economics, Management School, University of Liverpool, Liverpool, UK; Lifecode®, the Old Vicarage, Lindley, Huddersfield, UK.

BJOG : an International Journal of Obstetrics and Gynaecology
|June 5, 2014
PubMed

Insights

Adverse obstetric events causing cerebral palsy significantly reduce quality of life and survival. Prevention is possible, with outcomes varying by Gross Motor Function Classification System (GMFCS) severity.

Area of Science:

  • Neurology
  • Public Health
  • Medical Simulation

Background:

  • Cerebral palsy (CP) is a significant disability.
  • Adverse obstetric events can lead to CP.
  • Quantifying the impact of CP on life expectancy and quality of life is crucial for public health planning.

Purpose of the Study:

  • To determine the extent of cerebral palsy (CP) attributable to adverse obstetric events.
  • To estimate the lifetime mortality and morbidity expectations for individuals with CP compared to the general UK population.
  • To estimate the quality-adjusted life years (QALYs) lost due to asphyxia-related CP.

Main Methods:

  • A simulation model was developed using published data on CP incidence and aetiology.
  • A hypothetical cohort of UK live births in 2014 was simulated.
  • Survival and quality of life (QoL) were compared between individuals with CP and age-matched UK general population representatives.

Main Results:

  • An estimated 207 cases of asphyxia-related CP were projected for UK births in 2014.
  • Approximately 15.2 QALYs were lost per case of asphyxia-related CP.
  • The total QALYs lost were projected at 3142, valued at £62.9 million for the UK National Health Service.

Conclusions:

  • Intrapartum asphyxiation leading to CP significantly reduces QoL and survival.
  • CP with Gross Motor Function Classification System (GMFCS) levels 1 and 2 show near-normal lifetime QALYs.
  • GMFCS levels 3, 4, and 5 experience progressively reduced QALYs, with GMFCS 5 having negative QALYs.
Abstract

Keywords:
Cerebral palsyhealth economicsintrapartum care

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