Trends in cerebral palsy among of very low birthweight (<1500 g) or born prematurely (<32 weeks) in 16 European centres:: a database study
Trends in cerebral palsy among of very low birthweight (<1500 g) or born prematurely (<32 weeks) in 16 European centres:: a database study
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DOI：
10.1016/s0140-6736(07)60030-0
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发表时间：
2007-01-06
期刊：
影响因子：
168.9
通讯作者：
Krageloh-Mann, Inge
中科院分区：
文献类型：
--
作者：
Platt, Mary Jane;Cans, Christine;Krageloh-Mann, Inge
脑瘫是西欧儿童最常见的身体残疾，极低出生体重（VLBW）婴儿（出生体重低于1500克）和多胎妊娠婴儿患脑瘫的风险高于正常出生体重婴儿。这两个群体的婴儿存活到童年的比例越来越高。本文描述了1980- 1996年出生体重低于1000 g和1000-1499 g的婴儿脑瘫发病率和分布的性别和神经学亚型的变化。方法欧洲16个脑瘫监测中心对脑瘫的标准定义以及纳入和排除标准达成一致。1980- 1996年出生的脑瘫儿童的数据被汇总。对这些数据进行分析，以描述VLBW婴儿脑瘫的分布和患病率。流行趋势以每1000例活产和每1000例新生儿幸存者表示。发现1575例VLBW新生儿伴脑瘫；414例（26%）出生体重低于1000克，317例（20%）为多胎妊娠。1426例（94%）为痉挛性脑瘫，336例（24%）为单侧（偏瘫）。出生患病率从1980年的每1000名活产VLBW婴儿60.6例（99% CI 37.8-91.4）下降到1996年的每1000名VLBW婴儿39.5例（28.6-53.0）。这种下降与出生体重为1000-1499克的婴儿发生双侧痉挛性脑瘫的频率降低有关。出生体重在1000-1499 g组中，男婴脑瘫的发生率高于女婴（61.0 [53.8-68.2]vs 49.5[42.8-56.2] / 1000例活产；p=0.0025），而出生体重在1000 g以下组则无此现象。这些来自大量人口基础的数据提供了证据，证明出生体重低于1500克的儿童脑瘫患病率已经下降，这对父母、卫生服务机构和社会具有重要意义。
Background The risk of cerebral palsy, the commonest physical disability of children in western Europe, is higher in infants of very low birthweight (VLBW)-those born weighing less than 1500 g-and those from multiple pregnancies than in infants of normal birthweight. An increasing proportion of infants from both of these groups survive into childhood. This paper describes changes in the frequency and distribution of cerebral palsy by sex and neurological subtype in infants with a birthweight below 1000 g and 1000-1499 g in the period 1980-96.Methods A group of 16 European centres, Surveillance of Cerebral Palsy in Europe, agreed a standard definition of cerebral palsy and inclusion and exclusion criteria. Data for children with cerebral palsy born in the years 1980-96 were pooled. The data were analysed to describe the distribution and prevalence of cerebral palsy in VLBW infants. Prevalence trends were expressed as both per 1000 livebirths and per 1000 neonatal survivors.Findings There were 1575 VLBW infants born with cerebral palsy; 414 (26%) were of birthweight less than 1000 g and 317 (20%) were from multiple pregnancies. 1426 (94%) had spastic cerebral palsy, which was unilateral (hemiplegic) in 336 (24%). The birth prevalence fell from 60.6 (99% CI 37.8-91.4) per 1000 liveborn VLBW infants in 1980 to 39.5 (28.6-53.0) per 1000 VLBW infants in 1996. This decline was related to a reduction in the frequency of bilateral spastic cerebral palsy among infants of birthweight 1000-1499 g. The frequency of cerebral palsy was higher in male than female babies in the group of birthweight 1000-1499 g (61.0 [53.8-68.2] vs 49.5 [42.8-56.2] per 1000 livebirths; p=0.0025) but not in the group of birthweight below 1000 g.Interpretation These data from a large population base provide evidence that the prevalence of cerebral palsy in children of birthweight less than 1500 g has fallen, which has important implications for parents, health services, and society.