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. 2016 Jan;137(1):1-9.
doi: 10.1542/peds.2015-2872. Epub 2015 Dec 9.

Birth Prevalence of Cerebral Palsy: A Population-Based Study

Kim Van Naarden Braun  1 , Nancy Doernberg  2 , Laura Schieve  2 , Deborah Christensen  2 , Alyson Goodman  2 , Marshalyn Yeargin-Allsopp  2
Affiliations

Birth Prevalence of Cerebral Palsy: A Population-Based Study

Kim Van Naarden Braun et al. Pediatrics. 2016 Jan.

Abstract

Objective: Population-based data in the United States on trends in cerebral palsy (CP) birth prevalence are limited. The objective of this study was to examine trends in the birth prevalence of congenital spastic CP by birth weight, gestational age, and race/ethnicity in a heterogeneous US metropolitan area.

Methods: Children with CP were identified by a population-based surveillance system for developmental disabilities (DDs). Children with CP were included if they were born in metropolitan Atlanta, Georgia, from 1985 to 2002, resided there at age 8 years, and did not have a postneonatal etiology (n = 766). Birth weight, gestational age, and race/ethnicity subanalyses were restricted to children with spastic CP (n = 640). Trends were examined by CP subtype, gender, race/ethnicity, co-occurring DDs, birth weight, and gestational age.

Results: Birth prevalence of spastic CP per 1000 1-year survivors was stable from 1985 to 2002 (1.9 in 1985 to 1.8 in 2002; 0.3% annual average prevalence; 95% confidence interval [CI] -1.1 to 1.8). Whereas no significant trends were observed by gender, subtype, birth weight, or gestational age overall, CP prevalence with co-occurring moderate to severe intellectual disability significantly decreased (-2.6% [95% CI -4.3 to -0.8]). Racial disparities persisted over time between non-Hispanic black and non-Hispanic white children (prevalence ratio 1.8 [95% CI 1.5 to 2.1]). Different patterns emerged for non-Hispanic white and non-Hispanic black children by birth weight and gestational age.

Conclusions: Given improvements in neonatal survival, evidence of stability of CP prevalence is encouraging. Yet lack of overall decreases supports continued monitoring of trends and increased research and prevention efforts. Racial/ethnic disparities, in particular, warrant further study.

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Figures

FIGURE 1
FIGURE 1
Trends in birth prevalence of congenital CP per 1000 1-year survivors by subtype, birth years 1985 to 2002. aP < .05 for trend. bIncludes CP cases with ataxic, dyskinetic, mixed, and CP not otherwise specified. cTrend not significant when hypotonic CP cases are excluded.
FIGURE 2
FIGURE 2
Distribution of birth weight and gestational age among children with congenital spastic CP overall and by race/ethnicity, birth years 1985 to 2002. A, Birth weight. B, Gestational age.
See this image and copyright information in PMC

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