Temporal trends, clinical characteristics, and sociodemographic profile of post-neonatally acquired cerebral palsy in Australia, 1973-2012: A population-based observational study.
Emma Waight, Sarah McIntyre, Susan Woolfenden and 7 others
PMID 35665921WHAT IT FOUND
Post-neonatal cerebral palsy declined in two Australian states.
Cerebrovascular accidents were the most common cause. Among children born 1995 to 2012, 40% required assistive equipment for mobility, 32% were non-verbal, and 50% had active epilepsy.
Key findings
01Post-neonatal cerebral palsy birth prevalence fell over time in Victoria and Western Australia between 1973 and 2012, with a 7% decline per interval in Victoria and a fall from 2.3 to 1.6 per 10 000 live births in Western Australia.
02Cerebrovascular accidents were the most common recorded cause of post-neonatal cerebral palsy in children born 1995 to 2012, followed by infection and head injury, and non-accidental injury was the most common cause within head injury.
03Among children born 1995 to 2012, 40% had Gross Motor Function Classification System levels III to V, 29% had moderate to severe intellectual impairment, 32% were non-verbal, and 50% had active epilepsy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
The study was based on register data rather than a trial or a clinical intervention, so it can describe groups and trends but cannot show that any treatment caused an outcome. Numbers were small after the data were divided by cause, clinical factor, or sociodemographic factor, and confidence intervals were wide. Maternal age data were available for only two states. Specific cause details were limited, especially infection type and events classified as other post-neonatal injury. Some children with acquired brain injury who might meet cerebral palsy criteria may not have been registered. Remoteness and socioeconomic reference data used a more recent cohort, so they may not have been equally valid for earlier periods. State or territory data were excluded for a variable if more than 20% of that variable was missing.
Declared interests
Funding came from government, hospital, charity, and research bodies. The author HS-S received salary support from a National Health and Medical Research Council of Australia Early Career Fellowship and the Australasian Cerebral Palsy Clinical Trials Network. The Australian Capital Territory, New South Wales, and Australian CP registers were funded by the Cerebral Palsy Alliance Research Foundation. Other registers were funded by state health departments, hospital networks, and named organisations. The supplied text does not name a commercial company that sells a treatment.
The easy way to misread this
Do not read the lower prevalence or the cause associations as evidence that a clinical treatment prevented cerebral palsy. This was a register study of children already diagnosed, and the paper says numbers became small and confidence intervals wide after stratification.