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Prevalence of cerebral palsy in Alberta
C M Robertson1, L W Svenson, M R Joffres
1University of Alberta and Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada.
Insights
Cerebral palsy prevalence remains unchanged despite advances in perinatal care. This study found a prevalence of 2.57 per 1000 children, with low birthweight infants disproportionately affected.
Area of Science:
- Pediatrics
- Neurology
- Epidemiology
Background:
- Concerns persist regarding the unchanging frequency of cerebral palsy (CP) despite modern perinatal and neonatal care.
- Epidemiological data on cerebral palsy is limited, with a generally accepted prevalence of 2-2.5 per 1000 school-aged children.
Purpose of the Study:
- To determine the prevalence and identify risk factors for cerebral palsy in a contemporary cohort.
- To investigate the relationship between birthweight and cerebral palsy incidence.
Main Methods:
- A population-based record linkage study analyzed 96,359 children born between April 1985 and March 1988 in Alberta.
- Children were followed for eight years, with diagnostic codes for physician claims and hospital separations, along with birth data, collected.
- Cerebral palsy was identified using the ICD-9 code '343'.
Main Results:
- The overall childhood prevalence of cerebral palsy after age three was 2.57 per 1000 children.
- Congenital cases accounted for 92.3% of diagnoses, with 70% diagnosed before age three.
- Prevalence was significantly higher in low birthweight infants: 17.7 per 1000 for <2500g, 78.5 for <1500g, and 98.4 for <1000g.
Conclusions:
- Cerebral palsy continues to affect a substantial number of children, indicating no decrease in prevalence.
- The proportion of low birthweight children among those with cerebral palsy in this study was lower than previously reported in the literature.
Background:
In spite of scattered reports to the contrary, concern is continually expressed that the frequency of cerebral palsy has not decreased with modern perinatal/neonatal care. Overall, epidemiological information on cerebral palsy is scant. The generally accepted prevalence is 2 to 2.5 per thousand school-age children.
Methods:
A population-based record linkage study of a presently living cohort of 96,359 children born from April, 1985 through March, 1988 and followed over an eight-year tracking period captured the diagnostic codes for all fee-for-service physician claims, all hospital separations and individual birth data from the Department of Vital Statistics of the Government of Alberta. The ICD-9 code "343" was used to identify subjects. The childhood prevalence and frequency by birthweight-specific sub-groups of cerebral palsy after age three years (congenital, 229 [92.3%]; probable acquired 19 [7.7%]) were identified giving an overall prevalence of 2.57 per 1000. Seventy percent were diagnosed before their third birthday. Cohort prevalence of cerebral palsy for low birthweight children (< 2500 grams) was 17.7, very low birthweight (< 1500 grams), 78.5; and extremely low birthweight (< 1000 grams), 98.4. Low birthweight children made up just over one-third of cases in this study.
Conclusions:
Cerebral palsy continues to affect a significant number of children suggesting the prevalence of cerebral palsy has not decreased. The proportion of affected children with low birthweight in this study is less than that reported in the literature.