title: The incidence and implications of cerebral palsy following potentially avoidable obstetric complications: a preliminary burden of disease study.
abstract: OBJECTIVE
  To determine the extent of cerebral palsy attributable to adverse obstetric events, and estimate the lifetime mortality and morbidity expectations of these individuals relative to age-matched members of the UK general population.
  
  
  METHODS
  Simulation model.
  All projected live births during 2014.
  
  
  METHODS
  Using published data regarding the incidence and aetiology of cerebral palsy, we simulated the outcomes of a hypothetical cohort of UK live births. Survival and quality of life (QoL) for those with cerebral palsy were compared with age-matched individuals representative of the UK general population, in order to estimate the number of quality-adjusted life years (QALYs) lost following asphyxia-related cerebral palsy.
  
  
  METHODS
  Incidence of asphyxia-related cerebral palsy, QALYS, QoL, and survival.
  
  
  RESULTS
  A total of 207 (95% CI 169-245) cases of asphyxia-related cerebral palsy were projected amongst UK children born during the year 2014, with approximately 15.2 QALYs lost per case. If these results held true in a real birth cohort, 3142 (95% CI 2321-3963) QALYs would be lost as a consequence of asphyxia-related cerebral palsy, a loss valued by the UK National Health Service at £62.9 m (95% CI £46.4-79.3 m).
  
  
  CONCLUSIONS
  Cerebral palsy following intrapartum asphyxiation leads to significant reductions in QoL and survival; however, this may often be prevented. For those with GMFCS 1 and GMFCS 2 cerebral palsy (Gross Motor Function Classification System), lifetime QALYs accrued largely resemble those experienced by the UK general population, whereas for GMFCS 3 and GMFCS 4 QALYs are reduced considerably, and are negative in the case of GMFCS 5.
authors.affiliation: Liverpool Health Economics, Management School, University of Liverpool, Liverpool, UK; Lifecode®, the Old Vicarage, Lindley, Huddersfield, UK.
authors.forename: S
authors.initials: S
authors.lastname: Leigh
authors.forename: P
authors.initials: P
authors.lastname: Granby
authors.forename: M
authors.initials: M
authors.lastname: Turner
authors.forename: S
authors.initials: S
authors.lastname: Wieteska
authors.forename: A
authors.initials: A
authors.lastname: Haycox
authors.forename: B
authors.initials: B
authors.lastname: Collins
mesh_terms: D001237:Asphyxia / Q000150:complications / Q000453:epidemiology*; D002547:Cerebral Palsy / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D015331:Cohort Studies; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015233:Models, Statistical; D009010:Monte Carlo Method; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D019057:Quality-Adjusted Life Years; D006113:United Kingdom / Q000453:epidemiology
keywords: Cerebral palsy; health economics; intrapartum care