[Cerebral palsy as indicator of quality of neonatal care].
BACKGROUND
An investigation of the prevalence of cerebral palsy in relation to neonatal intensive care.


METHODS
Population based study in live-born children with birthweight > or = 500 g in the Norwegian county of Vestfold over the 25-year period 1970-94 (n = 58,448). Retrospective and prospective control of cases (cases with a postneonatal origin of cerebral palsy excluded) with a minimum follow-up to four years of age.


RESULTS
Cerebral palsy was diagnosed in 139 cases (2.4 per 1,000). The prevalence declined from 2.8 per 1,000 in the first five-year cohort born 1970-74, to 2.2 per 1,000 in children born in each of the three five-year cohorts born 1980-84, 1985-89, and 1990-94 (p = 0.24). The neonatal mortality rate declined significantly from 8.7 per 1,000 in the first to 2.8 per 1,000 in the last five-year cohort (p < 0.0001). The low birthweight (500-2,499 g) rate in live-born infants increased significantly in 1990-94 compared to 1985-89 (4.5% vs 3.9% respectively; p < 0.05). After a local ventilator treatment programme (operative from 1989) was established, transports of infants with severe respiratory distress syndrome to the regional hospital declined from 3 per 1,000 live-born infants to 1 per 1,000 (p < 0.0001).


CONCLUSIONS
A decentralised neonatal intensive care programme can be developed, with substantial decline in neonatal mortality without a corresponding increase in cerebral palsy prevalence.
Meberg
A
A
Barnesenteret Sentralsykehuset i Vestfold 3116 Tønsberg.
Broch
H
H
Irgens
L M
LM
D002547:Cerebral Palsy / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000592:standards*; D008297:Male; D009664:Norway / Q000453:epidemiology; D018743:Perinatal Care / Q000592:standards*; D015995:Prevalence; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies