Declining trends in birth prevalence and severity of singletons with cerebral palsy of prenatal or perinatal origin in Australia: A population-based observational study.
Hayley Smithers-Sheedy, Emma Waight, Shona Goldsmith and 8 others
PMID 35261024WHAT IT FOUND
The number of Australian singletons with cerebral palsy has dropped significantly.
This decline was seen in all gestational age groups, but was most pronounced in very preterm and term babies. The proportion of children with bilateral spasticity decreased, while those with dyskinetic or hypotonic presentations increased.
Key findings
01Birth prevalence of prenatal or perinatally acquired cerebral palsy in singletons declined by an average of 5% per 2-year epoch, falling from 1.8 to 1.2 per 1000 live births between 1995 and 2014.
02The decline in birth prevalence was significant across all gestational age groups, with the largest reductions observed in children born at less than 28 weeks and those born at term.
03The proportion of children with bilateral spastic cerebral palsy decreased, while the proportions with dyskinetic and hypotonic presentations increased over the study period.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Birth prevalence analyses were limited to three states (South Australia, Victoria, Western Australia) that accounted for 42% of the Australian population, so trends may not perfectly reflect the entire country. The study excluded children with postneonatal causes of cerebral palsy (brain injury after 28 days and before 2 years), so it does not describe trends in acquired CP. The increase in dyskinetic and hypotonic CP may be partly due to improved clinical identification and awareness rather than a true change in incidence, as suggested by the authors. The definition of 'singleton' may include a small number of children born from multiple pregnancies with early co-fetal loss, which is a known risk factor for CP.
Declared interests
The study was funded by the Royal Children's Hospital Foundation, Department of Health Western Australia, Cerebral Palsy Alliance Research Foundation, Australasian Cerebral Palsy Clinical Trials Network, and the National Health and Medical Research Council. No individual author conflicts of interest were explicitly declared in the provided text.
The easy way to misread this
Do not assume the increase in dyskinetic and hypotonic cerebral palsy represents a new biological cause or a failure of prevention. The authors suggest this rise may largely reflect improved clinical identification and awareness of these motor types over the last decade.