Decline in CP diagnoses in premature infants suggests improvements in perinatal care

Because cerebral palsy is a result of brain injury received shortly before, during, or soon after birth, the number of infants being diagnosed with the condition is a good indicator of the quality of perinatal and neonatal care. An article soon to be published in the Journal of Pediatrics indicates that the rates of cerebral palsy have declined dramatically in the past 15 years.

Dr. Ingrid van Haastert and colleagues from the University Medical Center Utrecht in The Netherlands studied nearly 3000 infants born prematurely between 1990 and 2005. They found that 2.2% of the infants born between 2002 and 2005 were diagnosed with cerebral palsy, down from 6.5% for those born between 1990 and 1993. Such a dramatic decrease in the rate of cerebral palsy diagnoses provides evidence that care for infants right before, during, and shortly after birth has improved in the last 15 years.

The researchers also found that children who were diagnosed with cerebral palsy between 2002 and 2005 were less severely affected by the condition than those diagnosed earlier in the study. Among the infants studied, the most important risk factors for developing severe cerebral palsy were large hemorrhages and/or white matter lesions in the brain. “We found that a decrease in the occurrence of extensive cystic white matter lesions was the main reason for the fall in severe cerebral palsy,” Dr. van Haastert explains.

The study, reported in “Decreasing Incidence and Severity of Cerebral Palsy in Prematurely Born Children” by Ingrid C van Haastert, PTT, MA, Floris Groenendaal, MD, PhD, Cuno S Uiterwaal, MD, PhD, Jacqueline U Termote, MD, PhD, Marja van der Heide-Jalving, MD, Maria J Eijsermans, PPT, PCS, Jan Willem Gorter, MD, PhD, Paul J Helders, MSc, PhD, Marian J Jongmans, MSc, PhD, Linda S de Vries, MD, PhD, appears in the Journal of Pediatrics, DOI: 10.1016/j.jpeds.2010.12.053, published by Elsevier.