1. UMR 1027 SPHERE Team, Inserm, Toulouse 3 Paul Sabatier University, Toulouse, France
2. Childhood Disability Registry in Haute-Garonne, University Hospital of Toulouse, Toulouse, France
3. Clinical Epidemiology Unit, University Hospital of Toulouse, Toulouse, France
4. School of Nursing & Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, United Kingdom
5. Central Remedial Clinic, Dublin, Ireland
6. Department of Child, Adolescent & Developmental Neurology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
7. Department of Paediatrics, Medical School, University of Pécs, Pécs, Hungary
8. Neonatology Intensive Care Unit/Research Center, Central Lisbon Hospital, Lisbon, Portugal
9. Child and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
10. Association Rehabilitation Center, Riga, Latvia
11. Department of Pediatrics, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
12. Department of Development and Regeneration, KU Leuven, Leuven, Belgium
13. Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
14. The Norwegian University of Science and Technology, NTNU, Trondheim, Norway
15. The Cerebral Palsy Register of Norway, Vestfold Hospital Trust, Tønsberg, Norway
16. Department of Paediatric Neurology, IASO Children's Hospital, Athens, Greece
17. Grenoble Alpes University, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, Grenoble, France
18. Registre des Handicaps de l'Enfant et Observatoire Périnatal, Grenoble, France
19. Norwich Medical School, University of East Anglia, Norwich, United Kingdom
20. Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Eberhard Karls Universität Tübingen, Tübingen, Germany
- Front Neurol. 2021 May 20;12:624884. doi: 10.3389/fneur.2021.624884.
Aim: To report on prevalence of cerebral palsy (CP), severity rates, and types of brain lesions in children born preterm 2004 to 2010 by gestational age groups.
Methods: Data from 12 population-based registries of the Surveillance of Cerebral Palsy in Europe network were used. Children with CP were eligible if they were born preterm (<37 weeks of gestational age) between 2004 and 2010, and were at least 4 years at time of registration. Severity was assessed using the impairment index. The findings of postnatal brain imaging were classified according to the predominant pathogenic pattern. Prevalences were estimated per 1,000 live births with exact 95% confidence intervals within each stratum of gestational age: ≤27, 28–31, 32–36 weeks. Time trends of both overall prevalence and prevalence of severe CP were investigated using multilevel negative binomial regression models.
Results: The sample comprised 2,273 children. 25.8% were born from multiple pregnancies. About 2-thirds had a bilateral spastic CP. 43.5% of children born ≤27 weeks had a high impairment index compared to 37.0 and 38.5% in the two other groups. Overall prevalence significantly decreased (incidence rate ratio per year: 0.96 [0.92–1.00[) in children born 32–36 weeks. We showed a decrease until 2009 for children born 28–31 weeks but an increase in 2010 again, and a steady prevalence (incidence rate ratio per year = 0.97 [0.92–1.02] for those born ≤27 weeks. The prevalence of the most severely affected children with CP revealed a similar but not significant trend to the overall prevalence in the corresponding GA groups. Predominant white matter injuries were more frequent in children born <32 weeks: 81.5% (≤27 weeks) and 86.4% (28–31 weeks), compared to 63.6% for children born 32–36 weeks.
Conclusion: Prevalence of CP in preterm born children continues to decrease in Europe excepting the extremely immature children, with the most severely affected children showing a similar trend.
Palavras Chave: cerebral palsy, preterm birth, prevalence, severity, brain imaging.