Epidemiology of cerebral palsy in Southern Denmark
Christina Frøslev-Friis1, Ulrike Dunkhase-Heinl, Johnny Dohn Holmgren Andersen
1Anæstesiklinik Sønderborg, Anæstesiologisk Center, Sygehus Sønderjylland, Sydvang 1, 6400 Sønderborg, Denmark. cfroeslevfriis@dadlnet.dk.
Insights
Cerebral palsy (CP) affects 2.4 per 1,000 births, with higher rates in preterm and multiple births. Reducing preterm and multiple pregnancies may prevent CP.
Area of Science:
- Neurology
- Pediatrics
- Public Health
Background:
- Cerebral palsy (CP) is a complex neurological disorder affecting movement and posture.
- Understanding CP prevalence, subtypes, and risk factors is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To determine the prevalence, subtypes, severity, and neuroimaging findings of cerebral palsy in Southern Denmark.
- To analyze risk factors and consider the etiology of CP in a defined birth cohort.
Main Methods:
- A population-based cohort study was conducted, analyzing 17,580 live births between 2003 and 2008.
- Data collection included diagnoses of CP, gestational age, birth weight, pregnancy type, and neuroimaging findings.
Main Results:
- The overall prevalence of CP was 2.4 per 1,000 live births, with significantly higher rates in preterm (<32 weeks GA) and multiple births.
- Spastic CP was the most common subtype. White-matter lesions were the predominant neuroimaging finding.
- Low gestational age and birth weight were identified as significant risk factors for CP.
Conclusions:
- The prevalence of CP in this cohort was higher than in other Scandinavian studies, potentially due to increased rates of preterm and multiple births.
- While neuroimaging abnormalities were common, the etiology of CP remained unknown in a majority of cases.
- Reducing preterm births and multiple pregnancies presents a primary prevention opportunity for cerebral palsy.
Introduction:
The aim of this study was to describe the prevalence, subtypes, severity and neuroimaging findings of cerebral palsy (CP) in a cohort of children born in Southern Denmark. Risk factors were analysed and aetiology considered.
Methods:
A population-based cohort study covering 17,580 live births from 2003 to 2008.
Results:
The study included 43 children diagnosed with CP. The overall prevalence of CP was 2.4 per 1,000 live births (95% confidence interval (CI): 1.8-3.2). The gestational age (GA)-specific prevalence ranged from 63.5 per 1,000 live births for GA < 32 weeks to 1.3 for GA ≥ 37 weeks. Almost half of the children were born preterm and 28% were from multiple pregnancies. The prevalence of CP was 1.8 per 1,000 in singletons and 15.4 per 1,000 in multiples. Low GA and birth weight were risk factors for CP, also after stratification for multiple births. Spastic CP was the predominating subtype of CP, and 24 children (56%) were able to walk independently. White-matter lesions were the most common magnetic resonance imaging finding, and the aetiology of CP was known in 37% of cases.
Conclusion:
The overall prevalence of CP was slightly higher than that found in other Scandinavian studies due to its higher prevalence in the preterm group. Possible explanations include the high rate of multiple births in the background population. Neuroimaging findings were abnormal in the majority of children with CP, but aetiology could only be established in one third of the children. Primary prevention of CP is possible if the numbers of preterm births and multiple pregnancies can be reduced.
Funding:
The Danish Cerebral Palsy Follow-up Programme is supported by the foundation "Ludvig og Sara Elsass Fond".
Trial Registration:
2008-58-0034.
