Birth Prevalence of Cerebral Palsy

The journal,Pediatrics, has published a CDC study that looked over time at how often cerebral palsy (CP) occurred in the population, also known as the birth prevalence¹ of CP. Over the past 50 years, major improvements in care during pregnancy and after birth have led to increased survival of babies, particularly among those born too early or too small, who are known to have a higher risk for having CP. This study found that the birth prevalence of spastic CP stayed about the same among children who were born from 1985 through 2002, rather than increasing as might be expected. The study also looked at whether the birth prevalence over time differed for children with CP who were in certain racial and ethnic groups, had certain birth characteristics, or had other developmental disabilities.

It is encouraging that the overall birth prevalence of CP has not gone up over time. However, the lack of an overall decrease in CP birth prevalence supports the need for continued tracking of CP birth prevalence and additional research and prevention efforts. Researchers, public health professionals, and policymakers can use this new information to:

• Support continued resources for children with CP and their families,
• Increase efforts to understand factors that might increase the risk for CP, and
• Target strategies to prevent CP.

You can read the abstract of the article here. Read more below for a summary of findings from this article.

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Main Findings

Note to readers: the results below are only among children with spastic CP (stiff muscles) that was congenital (related to brain damage that happened before or during birth)

Overall trends in birth prevalence

• The birth prevalence of CP among children stayed about the same over a 17-year period, fluctuating between 1 in 526 children born in 1985 and 1 in 555 children born in 2002.

Trends in birth prevalence of children with CP with other developmental disabilities

• The birth prevalence of children with CP with moderate to severe intellectual disability decreased about 2.6% each year from 1985 to 2002.
  • This trend suggests that improvements in care during pregnancy and after birth may be preventing more severe forms of CP.

Trends in birth prevalence of CP among children in certain racial and ethnic groups

• Birth prevalence of CP among black children was higher than among white and Hispanic children. The higher birth prevalence among black compared with white children continued over the 17-year period (see line graph above).
• CP birth prevalence among Hispanic children decreased from 1992 through 2002, although this was representative of a much smaller number of children than blacks or whites in metropolitan Atlanta.

Trends in birth prevalence of CP among children with certain birth characteristics

• Overall, there was no change over time in the CP birth prevalence among children born at certain birthweights or born after a certain number of months of pregnancy.
• However, black and white children with CP differed when looking at these birth characteristics.
  • Black children born at a normal weight or at full-term (after 37 or more weeks of pregnancy) were more likely to have CP than white children born at a normal weight or at full-term.
  • Black children and white children born at a very low birthweight (less than 3 pounds, 4 ounces) were about equally likely to have CP.
  • CP birth prevalence among white children born very low birthweight decreased by about half from 1985-1988 to 1998-2002.

About This Study

This study examined data from the Metropolitan Atlanta Developmental Disabilities Surveillance Program. Specifically, researchers analyzed data collected from the health and special education records of children who

• Were born in metropolitan Atlanta between 1985 and 2002,
• Lived in metropolitan Atlanta when they were 8 years old, and
• Had CP, but did not experience an event more than 28 days after birth which might have caused their CP (known as post-neonatal CP).

More Information

• To learn more about cerebral palsy, please visit www.cdc.gov/CP
• To learn more about the Metropolitan Atlanta Developmental Disabilities Surveillance Program, please visit www.cdc.gov/MADDSP

Key Findings Reference

Van Naarden Braun K, Doernberg N, Schieve L, Christensen D, Goodman A, Yeargin-Allsopp M. Birth prevalence of cerebral palsy: A population-based study. Pediatrics. [TBD}

1. In this study, CP birth prevalence is the number of children with CP born between 1985-2002 whose CP was not known to have been due to an event more than 28 days after birth (known as post-neonatal CP) divided by the total number of children born between 1985-2002 who survived until at least 1 year of age.