Increasing prevalence of cerebral palsy in children born very preterm in Denmark.

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Developmental Medicine and Child Neurology Pub Date : 2024-07-12 DOI:10.1111/dmcn.16020

Martha Veber Fogh, Gorm Greisen, Tine Dalsgaard Clausen, Lone Krebs, Mads Langager Larsen, Christina Engel Hoei-Hansen

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Abstract

Aim: To analyse the rising prevalence of cerebral palsy (CP) in children born preterm in Denmark.

Method: We included all live-born children born preterm in Denmark from 1997 to 2013. The prevalence of CP in children born preterm was categorized by gestational age and correlated with neonatal mortality and changes in clinical factors.

Results: Among 70 876 children, 824 (1.2%) had CP. The overall CP prevalence in children born preterm decreased substantially until 2001, from when it increased annually by 2.8% (95% confidence interval 0.6-5.0). When categorized, the prevalence only increased significantly in children born very preterm (gestational weeks 28-31). Neonatal mortality rates decreased steadily at all gestational ages during the entire study period. Clinical factors that changed during the study period were increasing numbers of high-risk pregnancies, maternal obesity, emergency caesarean sections, neonatal admissions, and usage of assisted ventilation.

Interpretation: The increasing prevalence of CP in children born preterm was driven by the subgroup born very preterm and matched their decrease in neonatal mortality. In similar population studies, decreased mortality was not followed by increased CP prevalence. An increase in clinical risk factors was unlikely to explain our findings, but more active neonatal life support may have played a role.

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丹麦早产儿脑瘫发病率不断上升。

目的：分析丹麦早产儿脑瘫（CP）发病率的上升趋势：我们纳入了 1997 年至 2013 年丹麦所有活产早产儿。早产儿脑瘫患病率按胎龄分类，并与新生儿死亡率和临床因素的变化相关联：在70 876名早产儿中，有824名（1.2%）患有CP。早产儿CP的总体患病率在2001年前大幅下降，此后每年增加2.8%（95%置信区间为0.6-5.0）。如果进行分类，只有极早产儿（孕周 28-31 周）的患病率才会显著增加。在整个研究期间，所有孕周的新生儿死亡率均稳步下降。研究期间发生变化的临床因素包括高危妊娠、孕产妇肥胖、紧急剖腹产、新生儿入院和使用辅助通气的数量增加：早产儿中CP发病率的增加是由极早产儿亚群推动的，与新生儿死亡率的下降相匹配。在类似的人群研究中，死亡率下降并不会导致CP患病率上升。临床风险因素的增加不太可能解释我们的研究结果，但更积极的新生儿生命支持可能起到了一定的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Developmental Medicine and Child Neurology 医学-临床神经学

CiteScore

7.80

自引率

13.20%

发文量

338

审稿时长

3-6 weeks

期刊介绍： Wiley-Blackwell is pleased to publish Developmental Medicine & Child Neurology (DMCN), a Mac Keith Press publication and official journal of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and the British Paediatric Neurology Association (BPNA). For over 50 years, DMCN has defined the field of paediatric neurology and neurodisability and is one of the world’s leading journals in the whole field of paediatrics. DMCN disseminates a range of information worldwide to improve the lives of disabled children and their families. The high quality of published articles is maintained by expert review, including independent statistical assessment, before acceptance.