Toggle Main Menu Toggle Search

Open Access padlockePrints

Increasing rates of cerebral palsy across the severity spectrum in north-east England 1964-1993

Lookup NU author(s): Professor Allan Colver, Emeritus Professor Stephen Jarvis, Dr Sam Richmond


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Objectives - To report epidemiological trends in cerebral palsy including analyses by severity. Design - Descriptive longitudinal study in north-east England. Every child with suspected cerebral palsy was examined by a developmental paediatrician to confirm the diagnosis. Severity of impact of disability was derived from a parent completed questionnaire already developed and validated for this purpose. Subjects - All children with cerebral palsy, not associated with any known postneonatal insult, born 1964- 1993 to mothers resident at the time of birth in the study area. Main outcome measures - Cerebral palsy rates by year, birth weight, and severity. Severity of 30% and above defines the more reliably ascertained cases; children who died before assessment at around 6 years of age are included in the most severe group (70% and above). Results - 584 cases of cerebral palsy were ascertained, yielding a rate that rose from 1.68 per 1000 neonatal survivors during 1964-1968 to 2.45 during 1989-1993 (rise = 0.77; 95% confidence interval 0.2-1.3). For the more reliably ascertained cases there was a twofold increase in rate from 0.98 to 1.96 (rise = 0.98; 95% confidence interval 0.5-1.4). By birth weight, increases in rates were from 29.8 to 74.2 per 1000 neonatal survivors < 1500 g and from 3.9 to 11.5 for those 1500-2499 g. Newborns < 2500 g now contribute one half of all cases of cerebral palsy and just over half of the most severe cases, whereas in the first decade of this study they contributed one third of all cases and only one sixth of the most severe (χ2 and χ2 for trend p < 0.001). Conclusions - The rate of cerebral palsy has risen in spite of falling perinatal and neonatal mortality rates, a rise that is even more pronounced when the mildest and least reliably ascertained are excluded. The effect of modern care seems to be that many babies < 2500 g who would have died in the perinatal period now survive with severe cerebral palsy. A global measure of severity should be included in registers of cerebral palsy to determine a minimum threshold for international comparisons of rates, and to monitor changes in the distribution of severity.

Publication metadata

Author(s): Colver AF; Jarvis SN; Richmond S; Gibson M; Hey EN; Mackie PC

Publication type: Article

Publication status: Published

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

Year: 2000

Volume: 83

Issue: 1

Pages: F7-F12

Print publication date: 01/01/2000

ISSN (print): 1359-2998

ISSN (electronic): 1743-0593

Publisher: BMJ Publishing Group Ltd


DOI: 10.1136/fn.83.1.F7

PubMed id: 10873162


Altmetrics provided by Altmetric