Prevalence Estimate of Cerebral Palsy in Northern Alberta: Births, 2008-2010
Charlene M T Robertson1, M Florencia Ricci1, Kathleen O'Grady2
11Department of Pediatrics,University of Alberta,Edmonton,Alberta,Canada.
Insights
Cerebral palsy (CP) affects 2.22 per 1000 children in Northern Alberta. The most common type is spastic CP, with hemiplegia being the most frequent subtype. Rates for preterm infants have decreased but remain similar for early gestations.
Area of Science:
- Pediatrics
- Neurology
- Epidemiology
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture, impacting approximately 1 in 300 children globally.
- Accurate prevalence data is crucial for resource allocation and understanding the condition's epidemiology.
- Previous Canadian studies on CP prevalence have varied in methodology and geographic scope.
Purpose of the Study:
- To establish the prevalence of cerebral palsy (CP) in 5-year-old children in Northern Alberta.
- To determine specific CP rates based on congenital factors, gestational age, birth weight, and postneonatal causes.
- To characterize the motor subtypes and functional abilities of children with CP.
Main Methods:
- A population-based study utilizing data from the Canadian Cerebral Palsy Registry.
- Inclusion criteria: confirmed CP diagnoses at age 5 years by pediatric rehabilitation and child neurology specialists.
- Prevalence rates calculated using Alberta government denominators for same-age children and live births, with 95% confidence intervals (CIs).
Main Results:
- The overall CP prevalence in Northern Alberta (birth years 2008-2010) was 2.22 per 1000 5-year-olds (95% CI 2.12, 2.32).
- Congenital CP rate was 1.99 per 1000 live births, with unilateral congenital CP at 1.0 per 1000 live births.
- Spastic CP was the most common motor subtype (87.6%), particularly hemiplegia (50%). Functional assessments indicated 63.3% ambulate independently and 65.7% have independent hand function.
Conclusions:
- Northern Alberta CP rates are comparable to those in other developed nations.
- The hemiplegic subtype remains the most prevalent among children with CP.
- While rates among preterm infants have declined, they remain similar for the earliest gestational age groups (<28 and 28-31 weeks).
Objectives:
The objectives of this study were to determine prevalence estimates of cerebral palsy (CP) among 5-year-old children in northern Alberta; to provide congenital, gestational age- and birth weight-specific, and postneonatal CP rates; and to describe motor subtypes and function.
Methods:
This population-based prevalence estimate study, part of the Canadian Cerebral Palsy Registry, reports confirmed CP diagnoses at age 5 years made by pediatric rehabilitation and child neurology specialists. Prevalence rates with 95% confidence intervals (CIs) used Alberta government denominators of same-age children and live births.
Results:
The Northern Alberta CP rate (birth years, 2008-2010) for 173 5-year-old children is 2.22 (95% CI 2.12, 2.32) per 1000 5-year-old children. The congenital CP rate is 1.99 (95% CI, 1.89-2.09) per 1000 live births; unilateral congenital CP, 1.0 (95% CI, 0.64-1.36) per 1000 live births; and postneonatal CP, 0.12 (95% CI, 0.1-0.14) per 1000 live births. Gestational age-specific rates are similar: age <28 weeks, 27.2 (95% CI, 23.05-31.35) and 28 to 31 weeks, 29.5 (95% CI, 25.78-33.22). Motor subtypes for 169 children (data missing, 4; male, 97; postnatal, 9) are: spastic, 148 (87.6%) including 31 (20.9%) with diplegia, 10 (6.8%) triplegia, 33 (22.2%) quadriplegia, 74 (50%) hemiplegia/monoplegia); and dyskinetic, 18 (10.6%) and ataxic, 3 (1.8%). A total of 107 (63.3%) ambulate without assistive devices and 111(65.7%) handle most objects with their hands independently.
Conclusions:
This is the fourth Canadian CP prevalence study; one from Quebec used a similar case ascertainment approach and two 1980s studies from Alberta and British Columbia used administrative databases. Northern Alberta CP rates are comparable with other developed countries. The hemiplegic subtype is the most common. Rates among preterm children have declined but are similar for the <28 and 28 to 31 gestation-week groups.
