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Space-Time Clustering Analyses of Occurrence of Cerebral Palsy in Northern England for Births 1991 to 2003

Lookup NU author(s): Dr Richard McNallyORCiD, Emeritus Professor Allan ColverORCiD


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Purpose: The etiology of congenital cerebral palsy is unclear. Recent studies have suggested that maternal infection is involved. Indirect, but supportive, evidence for an infectious hypothesis would be provided by the finding of space-time clustering. Methods: We analyzed all 906 cases born during the period 1991-2003 using a population-based registry from Northern England. We applied the K-function method for testing global space-time clustering and used residential addresses at the time of birth. The Knox method was used to determine the spatio-temporal range over which global clustering occurred. Tests were repeated using nearest neighbor thresholds to allow for variable population density. Additionally, Kulldorff's scan statistic identified specific space-time clusters. Results: There was statistically significant evidence of global space-time clustering (p ≤ 0.05). Clustering occurred over a range of close distances, but was most pronounced for cases born within 1-4 months of one another. A specific space-time cluster was identified during 1994. Conclusions: The application of spatial statistics for the study of cerebral palsy is novel. There is tentative evidence for the involvement of spatially and temporally varying environmental etiological factors. These findings may support a role for infections or similar agents. However, the role of chance cannot be excluded. © 2008 Elsevier Inc. All rights reserved.

Publication metadata

Author(s): McNally RJQ, Colver AF

Publication type: Article

Publication status: Published

Journal: Annals of Epidemiology

Year: 2008

Volume: 18

Issue: 2

Pages: 108-112

ISSN (print): 1047-2797

ISSN (electronic): 1873-2585

Publisher: Elsevier Inc.


DOI: 10.1016/j.annepidem.2007.07.104

PubMed id: 17855120


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