Abstract
The epidemiology of cerebral palsy includes studies across whole populations within a defined geographic area that center on determining the frequency of the condition; identifying patterns, risk factors, and causal pathways; and evaluating the effectiveness of interventions for prevention and reducing severity. This chapter uses population data from long-standing registers to give an update on these studies. The rates of cerebral palsy in developed countries have fluctuated between 1.5 and 3/1000 live births throughout the last 50 years. There have been periods of reducing rates, which have been followed by increases in rates. We are currently in another decline, and the question is as follows: Can this decline continue under 1.5/1000 live births for the first time? It is now becoming increasingly important to measure frequencies in low- and middle-income countries, where frequencies are expected to be higher, but with possibilities for primary prevention. Patterns have emerged among gestational age and birth weight categories as well as motor type and topographic distributions. We understand more about causal pathways that include preterm birth, multiple births, infection, and congenital anomalies which open more doors to primary prevention and reduced severity than when research was simply focused on birth asphyxia.
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References
ACPR Group (2016) Report of the Australian Cerebral Palsy Register, Birth Years 1993–2009 www.cpregister.com/pubs/pdf/ACPR-Report_Web_2016.pdf
Adler SP, Finney JW, Manganello AM, Best AM (1996) Prevention of child-to-mother transmission of cytomegalovirus by changing behaviours: a randomized controlled trial. Pediatr Infect Dis J 15:240–246
Adler SP, Finney JW, Manganello AM, Best AM (2004) Prevention of child-to-mother transmission of cytomegalovirus among pregnant women. J Pediatr 145:485–491
Ahlin K, Jacobsson B, Nilsson S, Himmelmann K (2017) Antecedents and neuroimaging patterns in cerebral palsy with epilepsy and cognitive impairment: a population-based study in children born at term. Acta Obstet Gynecol Scand 96:828–836. https://doi.org/10.1111/aogs.13128
Banerjee TK et al (2009) Neurological disorders in children and adolescents. Indian J Pediatr 76:139–146. https://doi.org/10.1007/s12098-008-0226-z
Barty E, Caynes K, Johnston LM (2016) Development and reliability of the Functional Communication Classification System for children with cerebral palsy. Dev Med Child Neurol 58:1036–1041. https://doi.org/10.1111/dmcn.13124
Bearden DR et al (2016) Pediatric Cerebral Palsy in Botswana: etiology, outcomes, and comorbidities. Pediatr Neurol 59:23–29. https://doi.org/10.1016/j.pediatrneurol.2016.03.002
Beckung E, Hagberg G (2002) Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol 44:309–316
Beckung E, Hagberg G, Uldall P, Cans C, Surveillance of Cerebral Palsy in E (2008) Probability of walking in children with cerebral palsy in Europe. Pediatr 121:e187–e192. https://doi.org/10.1542/peds.2007-0068
Benfer KA, Jordan R, Bandaranayake S, Finn C, Ware RS, Boyd RN (2014) Motor severity in children with cerebral palsy studied in a high-resource and low-resource country. Pediatr 134:e1594–e1602. https://doi.org/10.1542/peds.2014-1926
Blair E, Watson L, Badawi N, Stanley FJ (2001) Life expectancy among people with cerebral palsy in Western Australia. Dev Med Child Neurol 43:508–515
Blair E, Al Asedy F, Badawi N, Bower C (2007) Is cerebral palsy associated with birth defects other than cerebral defects? Dev Med Child Neurol 49:252–258. https://doi.org/10.1111/j.1469-8749.2007.00252.x
Brooks JC, Strauss DJ, Shavelle RM, Tran LM, Rosenbloom L, Wu YW (2014) Recent trends in cerebral palsy survival. Part I: period and cohort effects. Dev Med Child Neurol 56:1059–1064. https://doi.org/10.1111/dmcn.12520
Cannon MJ, Davis KF (2005) Washing our hands of the congenital cytomegalovirus disease epidemic. BMC Public Health 5:70. https://doi.org/10.1186/1471-2458-5-70
Cans C, Dolk H, Platt MJ, Colver A, Prasauskiene A, Krageloh-Mann I, SCPE Collaborative Group (2007) Recommendations from the SCPE collaborative group for defining and classifying cerebral palsy. Dev Med Child Neurol Suppl 109:35–38
Cans C, De La Cruz J, Mermet M (2008) Epidemiology of cerebral palsy. Symposium: special needs. Paediatr Child Health 18:393–398
Carlsson M, Olsson I, Hagberg G, Beckung E (2008) Behaviour in children with cerebral palsy with and without epilepsy. Dev Med Child Neurol 50:784–789. https://doi.org/10.1111/j.1469-8749.2008.03090.x
Couper J (2002) Prevalence of childhood disability in rural KwaZulu-Natal. S Afr Med J 92:549–552
Delobel-Ayoub M, Klapouszczak D, van Bakel MME, Horridge K, Sigurdardottir S, Himmelmann K, Arnaud C (2017) Prevalence and characteristics of autism spectrum disorders in children with cerebral palsy. Dev Med Child Neurol 59:738–742. https://doi.org/10.1111/dmcn.13436
Dyer S et al (2016) International committee for monitoring assisted reproductive technologies world report: assisted reproductive technology 2008, 2009 and 2010. Hum Reprod 31:1588–1609. https://doi.org/10.1093/humrep/dew082
Eliasson A-C, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall A-M, Rosenbaum P (2006) The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol 48:549–554
El-Tallawy HN, Farghaly WM, Shehata GA, Metwally NA, Rageh TA, Abo-Elfetoh N (2011) Epidemiology of cerebral palsy in El-Kharga District-New Valley (Egypt). Brain and Development 33:406–411. https://doi.org/10.1016/j.braindev.2010.07.011
El-Tallawy HN et al (2014) Cerebral palsy in Al-Quseir City, Egypt: prevalence, subtypes, and risk factors. Neuropsychiatr Dis Treat 10:1267–1272. https://doi.org/10.2147/NDT.S59599
Elvrum AK, Andersen GL, Himmelmann K, Beckung E, Ohrvall AM, Lydersen S, Vik T (2016) Bimanual Fine Motor Function (BFMF) classification in children with cerebral palsy: aspects of construct and content validity. Phys Occup Ther Pediatr 36:1–16. https://doi.org/10.3109/01942638.2014.975314
EURO-PERISTAT Project with SCPE EUROCAT & EURONEOSTAT (2008) European Perinatal Health Report www.europeristat.com/images/doc/EPHR/european-perinatal-health-report.pdf
Gladstone M (2010) A review of the incidence and prevalence, types and aetiology of childhood cerebral palsy in resource-poor settings. Ann Trop Paediatr 30:181–196. https://doi.org/10.1179/146532810X12786388978481
Goldsmith S et al (2016) An international survey of cerebral palsy registers and surveillance systems. Dev Med Child Neurol 58(Suppl 2):11–17. https://doi.org/10.1111/dmcn.12999
Goldsmith S, Jalon GG, Badawi N, Blair E, Garne E, Gibson C, McIntyre S, Scott H, Smithers-Sheedy H, Andersen GL (2018) Comprehensive investigation of congenital anomalies in cerebral palsy: protocol for a European-Australian population-based data linkage study (The Comprehensive CA-CP Study). BMJ Open 8(7):e022190. https://doi.org/10.1136/bmjopen-2018-022190
Hagberg B, Hagberg G, Olow I (1982) Gains and hazards of intensive neonatal care: an analysis from Swedish Cerebral palsy epidemiology. Dev Med Child Neurol 24:13–19
Hidecker MJ et al (2011) Developing and validating the Communication Function Classification System for individuals with cerebral palsy. Dev Med Child Neurol 53:704–710. https://doi.org/10.1111/j.1469-8749.2011.03996.x
Himmelmann K, Sundh V (2015) Survival with cerebral palsy over five decades in western Sweden. Dev Med Child Neurol 57:762–767. https://doi.org/10.1111/dmcn.12718
Himmelmann K, Uvebrant P (2011) Function and neuroimaging in cerebral palsy: a population-based study. Dev Med Child Neurol 53:516–521. https://doi.org/10.1111/j.1469-8749.2011.03932.x
Himmelmann K, Uvebrant P (2014) The panorama of cerebral palsy in Sweden. XI. Changing patterns in the birth-year period 2003–2006. Acta Pediatr 103:618–624. https://doi.org/10.1111/apa.12614
Himmelmann K, Beckung E, Hagberg G, Uvebrant P (2006) Gross and fine motor function and accompanying impairments in cerebral palsy. Dev Med Child Neurol 48:417–423. https://doi.org/10.1017/S0012162206000922
Himmelmann K, McManus V, Hagberg G, Uvebrant P, Krageloh-Mann I, Cans C, Collaboration S (2009) Dyskinetic cerebral palsy in Europe: trends in prevalence and severity. Arch Dis Child 94:921–926. https://doi.org/10.1136/adc.2008.144014
Himmelmann K et al (2017) MRI classification system (MRICS) for children with cerebral palsy: development, reliability, and recommendations. Dev Med Child Neurol 59:57–64. https://doi.org/10.1111/dmcn.13166
Hvidtjorn D, Schieve L, Schendel D, Jacobsson B, Svaerke C, Thorsen P (2009) Cerebral palsy, autism spectrum disorders, and developmental delay in children born after assisted conception: a systematic review and meta-analysis. Arch Pediatr Adolesc Med 163:72–83. https://doi.org/10.1001/archpediatrics.2008.507
Hvidtjorn D et al (2010) Multiplicity and early gestational age contribute to an increased risk of cerebral palsy from assisted conception: a population-based cohort study. Hum Reprod 25:2115–2123. https://doi.org/10.1093/humrep/deq070
Jarvis S et al (2003) Cerebral palsy and intrauterine growth in single births: European collaborative study. Lancet 362:1106–1111. https://doi.org/10.1016/S0140-6736(03)14466-2
Kakooza-Mwesige A, Forssberg H, Eliasson AC, Tumwine JK (2015) Cerebral palsy in children in Kampala, Uganda: clinical subtypes, motor function and co-morbidities. BMC Res Notes 8:166. https://doi.org/10.1186/s13104-015-1125-9
Kallen B (2014) The risk of neurodisability and other long-term outcomes for infants born following ART. Semin Fetal Neonatal Med 19:239–244. https://doi.org/10.1016/j.siny.2014.04.002
Kallen AJ, Finnstrom OO, Lindam AP, Nilsson EM, Nygren KG, Olausson PM (2010) Cerebral palsy in children born after in vitro fertilization. Is the risk decreasing? Eur J Paediatr Neurol 14:526–530. https://doi.org/10.1016/j.ejpn.2010.03.007
Kenneson A, Cannon MJ (2007) Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol 17:253–276. https://doi.org/10.1002/rmv.535
Khandaker G et al (2015) Bangladesh Cerebral Palsy Register (BCPR): a pilot study to develop a national cerebral palsy (CP) register with surveillance of children for CP. BMC Neurol 15:173. https://doi.org/10.1186/s12883-015-0427-9
Kilincaslan A, Mukaddes NM (2009) Pervasive developmental disorders in individuals with cerebral palsy. Dev Med Child Neurol 51:289–294. https://doi.org/10.1111/j.1469-8749.2008.03171.x
Krägeloh-Mann I, Petersen D, Hagberg G, Vollmer B, Hagberg B, Michaelis R (1995) Bilateral spastic cerebral palsy-MRI pathology and origin. Analysis from a representative series of 56 cases. Dev Med Child Neurol 37(5):379–97
Krägeloh-Mann I, Helber A, Mader I, Staudt M, Wolff M, Groenendaal F, DeVries L (2002) Bilateral lesions of thalamus and basal ganglia: origin and outcome. Dev Med Child Neurol 44(7):477–84
Krägeloh-Mann I (2004) Imaging of early brain injury and cortical plasticity. Exp Neurol 190(Suppl 1):S84–S90. https://doi.org/10.1016/j.expneurol.2004.05.037
Krägeloh-Mann I, Petruch UR, Gainsborough M on behalf of the SCPE working group et al (2003) The Reference and Training Manual (RTM) of the Surveillance of Cerebral Palsy in Europe, SCPE – a video and text based interactive CD-ROM. In: EACD meeting, October 2003
Manicklal S, Emery VC, Lazzarotto T, Boppana SB, Gupta RK (2013) The “silent” global burden of congenital cytomegalovirus. Clin Microbiol Rev 26:86–102. https://doi.org/10.1128/CMR.00062-12
McIntyre S et al (2016) Congenital anomalies in cerebral palsy: where to from here? Dev Med Child Neurol 58(Suppl 2):71–75
Monbaliu E et al (2017) Clinical presentation and management of dyskinetic cerebral palsy. Lancet Neurol 16:741–749. https://doi.org/10.1016/S1474-4422(17)30252-1
Pennington L et al (2013) Development of the Viking Speech Scale to classify the speech of children with cerebral palsy. Res Dev Disabil 34:3202–3210
Petterson B, Nelson KB, Watson L, Stanley F (1993) Twins, triplets, and cerebral palsy in births in Western Australia in the 1980s. BMJ 307:1239–1243
Pharoah PO, Cooke T (1996) Cerebral palsy and multiple births. Arch Dis Child Fetal Neonatal Ed 75:F174–F177
Platt MJ, Cans C, Johnson A, Surman G, Topp M, Torrioli MG, Krageloh-Mann I (2007) Trends in cerebral palsy among infants of very low birthweight (<1500 g) or born prematurely (<32 weeks) in 16 European centres: a database study. Lancet 369:43–50. https://doi.org/10.1016/S0140-6736(07)60030-0
Pueyo R, Junque C, Vendrell P, Narberhaus A, Segarra D (2009) Neuropsychologic impairment in bilateral cerebral palsy. Pediatr Neurol 40:19–26. https://doi.org/10.1016/j.pediatrneurol.2008.08.003
Rankin J et al (2010) Congenital anomalies in children with cerebral palsy: a population-based record linkage study. Dev Med Child Neurol 52:345–351. https://doi.org/10.1111/j.1469-8749.2009.03415.x
Rawlinson WD et al (2017) Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. Lancet Infect Dis 17:e177–e188. https://doi.org/10.1016/S1473-3099(17)30143-3
Reid SM, Carlin JB, Reddihough DS (2011) Distribution of motor types in cerebral palsy: how do registry data compare? Dev Med Child Neurol 53:233–238. https://doi.org/10.1111/j.1469-8749.2010.03844.x
Reid SM, Carlin JB, Reddihough DS (2012) Survival of individuals with cerebral palsy born in Victoria, Australia, between 1970 and 2004. Dev Med Child Neurol 54:353–360. https://doi.org/10.1111/j.1469-8749.2012.04218.x
Reid SM, Meehan E, McIntyre S, Goldsmith S, Badawi N, Reddihough DS, on behalf of the Australian Cerebral Palsy Register Group (2016) Temporal trends in cerebral palsy by impairment severity and birth gestation. Dev Med Child Neurol 58(Suppl 2):25–35. https://doi.org/10.1111/dmcn.13001
Revello MG et al (2015) Prevention of primary cytomegalovirus infection in pregnancy. EBioMedicine 2:1205–1210. https://doi.org/10.1016/j.ebiom.2015.08.003
Rosenbaum PL et al (2002) Prognosis for gross motor function in cerebral palsy: creation of motor development curves. JAMA 288:1357–1363
Rosenbaum P et al (2007) A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 109:8–14
Scher AI et al (2002) The risk of mortality or cerebral palsy in twins: a collaborative population-based study. Pediatr Res 52:671–681. https://doi.org/10.1203/00006450-200211000-00011
Sellier E, Platt MJ, Andersen GL, Krageloh-Mann I, De La Cruz J, Cans C, Surveillance of Cerebral Palsy N (2016) Decreasing prevalence in cerebral palsy: a multi-site European population-based study, 1980 to 2003. Dev Med Child Neurol 58:85–92. https://doi.org/10.1111/dmcn.12865
Serdaroglu A, Cansu A, Ozkan S, Tezcan S (2006) Prevalence of cerebral palsy in Turkish children between the ages of 2 and 16 years. Dev Med Child Neurol 48:413–416. https://doi.org/10.1017/S0012162206000910
Serenius F et al (2013) Neurodevelopmental outcome in extremely preterm infants at 2.5 years after active perinatal care in Sweden. JAMA 309:1810–1820. https://doi.org/10.1001/jama.2013.3786
Sharp M, French N, McMichael J, Campbell C (2017) Survival and neurodevelopmental outcome in extremely preterm infants: 22–24 weeks of gestation born in Western Australia. J Paediatr Child Health. https://doi.org/10.1111/jpc.13678
Shepherd E, Middleton P, Makrides M, McIntyre S, Badawi N, Crowther CA (2016) Neonatal interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD012409
Shepherd E, Salam RA, Middleton P, Makrides M, McIntyre S, Badawi N, Crowther C (2017) Antenatal and intrapartum interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD012077
Singhi P, Saini AG (2013) Changes in the clinical spectrum of cerebral palsy over two decades in North India – an analysis of 1212 cases. J Trop Pediatr 59:434–440. https://doi.org/10.1093/tropej/fmt035
Smithers-Sheedy H et al (2014) What constitutes cerebral palsy in the twenty-first century? Dev Med Child Neurol 56:323–328. https://doi.org/10.1111/dmcn.12262
Smithers-Sheedy H et al (2017) Congenital cytomegalovirus among children with Cerebral Palsy. J Pediatr 181:267–271 e261. https://doi.org/10.1016/j.jpeds.2016.10.024
Surveillance of Cerebral Palsy in Europe (2000) Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE). Dev Med Child Neurol 42:816–824
Surveillance of Cerebral Palsy in Europe (2002) Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol 44:633–640
Topp M, Huusom LD, Langhoff-Roos J, Delhumeau C, Hutton JL, Dolk H, SCPE Collaborative Group (2004) Multiple birth and cerebral palsy in Europe: a multicenter study. Acta Obstet Gynecol Scand 83:548–553. https://doi.org/10.1111/j.0001-6349.2004.00545.x
Van Naarden Braun K, Doernberg N, Schieve L, Christensen D, Goodman A, Yeargin-Allsopp M (2016) Birth Prevalence of Cerebral Palsy: a Population-Based Study. Pediatrics 137. https://doi.org/10.1542/peds.2015-2872
Vauloup-Fellous C, Picone O, Cordier AG, Parent-du-Chatelet I, Senat MV, Frydman R, Grangeot-Keros L (2009) Does hygiene counseling have an impact on the rate of CMV primary infection during pregnancy? Results of a 3-year prospective study in a French hospital. J Clin Virol 46(Suppl 4):S49–S53. https://doi.org/10.1016/j.jcv.2009.09.003
Venkateswaran S, Shevell MI (2008) Comorbidities and clinical determinants of outcome in children with spastic quadriplegic cerebral palsy. Dev Med Child Neurol 50:216–222. https://doi.org/10.1111/j.1469-8749.2008.02033.x
Watson L, Blair E, Stanley F (2006) Report of the Western Australian Cerebral Palsy Register to Birth Year 1999. Telethon Institute for Child Health Research, Perth
Westbom L, Bergstrand L, Wagner P, Nordmark E (2011) Survival at 19 years of age in a total population of children and young people with cerebral palsy. Dev Med Child Neurol 53:808–814. https://doi.org/10.1111/j.1469-8749.2011.04027.x
Wilson-Costello D, Friedman H, Minich N, Fanaroff AA, Hack M (2005) Improved survival rates with increased neurodevelopmental disability for extremely low birth weight infants in the 1990s. Pediatrics 115:997–1003. https://doi.org/10.1542/peds.2004-0221
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Himmelmann, K., McIntyre, S., Goldsmith, S., Smithers-Sheedy, H., Watson, L. (2018). Epidemiology of Cerebral Palsy. In: Miller, F., Bachrach, S., Lennon, N., O'Neil, M. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-319-50592-3_9-1
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