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Cerebral palsy--trends in incidence and changes in concurrent neonatal mortality: Rochester, MN, 1950-1976
Insights
Cerebral palsy (CP) incidence decreased overall, particularly for spastic CP, with declining neonatal mortality. However, this reduction in CP risk was primarily observed in infants with birthweights over 2,500 grams.
Area of Science:
- Neurology
- Pediatrics
- Public Health
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture.
- Understanding trends in CP incidence is crucial for public health initiatives.
- Neonatal survival rates have improved significantly over recent decades.
Purpose of the Study:
- To analyze the incidence rates of cerebral palsy over a 27-year period.
- To investigate trends in CP incidence stratified by birthweight.
- To correlate changes in CP incidence with neonatal mortality rates.
Main Methods:
- Retrospective cohort study of all identified cerebral palsy cases.
- Population-based study in Rochester, MN, over 27 years.
- Calculation of incidence rates per 1,000 neonatal survivors across three 9-year intervals.
Main Results:
- Overall CP incidence declined from 2.3 to 1.6 per 1,000 neonatal survivors.
- Spastic CP incidence showed a more marked decline, from 2.1 to 0.9.
- CP incidence in low birthweight neonates remained unchanged despite decreased neonatal mortality.
Conclusions:
- The overall incidence of cerebral palsy has declined, linked to improved neonatal care.
- The reduction in CP risk was predominantly seen in infants weighing over 2,500 grams at birth.
- Further research is needed to address CP prevention in low birthweight populations.
Abstract:
We studied all identified cases of cerebral palsy (CP) born to residents of Rochester, MN, during a 27-year period. Incidence rates per 1,000 neonatal survivors were computed for three 9-year intervals. For children with persisting findings, the incidence rate of all syndromes declined from 2.3 to 1.6. For spastic syndromes, this trend was more marked (2.1 to 0.9). For newborns with birthweight over 2,500 g, both CP incidence and neonatal mortality rates (NMR) declined in parallel. For the low birthweight neonate, coincident with a precipitous drop in NMR, the CP incidence rate remained essentially unchanged. In the face of increasing neonatal survival, the overall incidence rate of CP declined. The decrease in the absolute risk of CP was limited to the greater than 2,500-g neonatal survivor.