Toggle Main Menu Toggle Search

Open Access padlockePrints

Decreasing cerebral palsy prevalence in multiple births in the modern era: A population cohort study of European data

Lookup NU author(s): Professor Judith Rankin



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Multiple births (twins or higher order multiples) are increasing in developed countries and may present higher risk for cerebral palsy (CP). However, few studies can reliably investigate trends over time because these outcomes are relatively rare. Objective: We pooled data from European CP registers to investigate CP birth prevalence and its trends among single and multiple births born between 1990 and 2008. Design: Population cohort study. Setting: 12 population-based registers from the Surveillance of Cerebral Palsy in Europe collaboration. Participants: 4 446 125 single and multiple live births, of whom 8416 (0.19%) had CP of prenatal or perinatal origin. Main outcomes: CP diagnosis ascertained in childhood using harmonised methods; CP subtype; Motor impairment severity among CP cases. Results: The rate of multiple births increased from 1990. Multiples displayed higher risk for CP (RR=4.27, 95% CI 4.00 to 4.57). For singletons and multiples alike, risk for CP was higher among births of lower gestational age (GA) or birth weight (BW). However, CP birth prevalence declined significantly among very preterm (<32 weeks) and very low BW (<1500 g) multiples. Singletons and multiples with CP displayed similar severity of motor impairment. Conclusions: Between 1990 and 2008, CP birth prevalence decreased steadily among multiples with low GA or BW. Furthermore, multiples with CP display similar profiles of severe motor impairment compared with CP singletons. Improvements in management of preterm birth since the 1990s may also have been responsible for providing better prospects for multiples.

Publication metadata

Author(s): Perra O, Rankin J, Platt MJ, Sellier E, Arnaud C, De La Cruz J, Krageloh-Mann I, Sweet DG, Bjellmo S

Publication type: Article

Publication status: Published

Journal: Archives of Disease in Childhood: Fetal and Neonatal Edition

Year: 2021

Volume: 106

Issue: 2

Pages: 125-130

Print publication date: 01/03/2021

Online publication date: 26/08/2020

Acceptance date: 15/06/2020

Date deposited: 06/01/2021

ISSN (print): 1359-2998

ISSN (electronic): 1468-2052

Publisher: BMJ Publishing Group


DOI: 10.1136/archdischild-2020-318950

PubMed id: 32847831


Altmetrics provided by Altmetric


Funder referenceFunder name
European Commission (SCPE-NET 2008 13 07/FIB_H120_FY2014 OG