[A changing panorama of cerebral palsy? A population-based study of children born during the 20-year period 1970-89].
In a population-based study cerebral palsy was diagnosed in 110 cases (2.4 per 1,000) among live born children with birth weight > or = 500 g (N = 45,976) during the 20-year period 1970-89 (cerebral palsy cases with a postneonatal etiology excluded). The incidence of cerebral palsy showed a linear declining trend from 2.8 per 1,000 in the first five-year cohort born 1970-74 to 2.0 per 1,000 in children born 1985-89 (p = 0.17). 15.9% of the decline in incidence of cerebral palsy from the first to the second ten-year cohort could be explained by a decreasing rate of low birth weight (500-2,499 g) in the population, from 4.2% 1970-79 to 3.8% 1980-89 (p < 0.05). The neonatal mortality rate declined significantly from 7.2 per 1,000 in the first to 3.9 per 1,000 in the last ten-year cohort respectively (p < 0.01). More children with cerebral palsy born in the ten-year period 1980-89 were treated with mechanical ventilation in the neonatal period (13/46; 28.3%) than such children born in the ten-year period 1970-79 (4/64; 6.3%) (p < 0.01). The results contrast with the traditional findings of a higher incidence of cerebral palsy incidence following improved survival of infants with low birth weight. Our results may reflect a more integrated development of perinatal care. Research on ways of preventing low birth weight may allow us to lower the incidence of cerebral palsy still further.
Meberg
A
A
Barneavdelingen, Vestfold sentralsykehus, Tłnsberg.
Broch
H
H
D002547:Cerebral Palsy / Q000175:diagnosis* / Q000453:epidemiology / Q000266:history; D015331:Cohort Studies; D049673:History, 20th Century; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000453:epidemiology; D015931:Intensive Care, Neonatal / Q000592:standards; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D011785:Quality Assurance, Health Care