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Cerebral palsy (CP) is the most common cause of significant motor impairment in childhood. Advances in antenatal and neonatal intensive care since the 1970s have resulted in improved survival of very preterm and very low birth weight (VLBW) infants, accompanied by an increase in CP rates in these groups. 1 - 5 More recently a declining trend in CP rates in such small infants has been observed, 5 - 7 and in some reports the decline is accompanied by a reduction in severity. 8 Against this welcome trend, there has been no decrease in rates of CP in normal birth weight and term infants, 7 - 9 who account for about a half of all children with CP.
The aim of this study is to investigate changes in CP rates in the North of England for 1991-2000 births in relation to birth weight, gestational age, severity of disability, clinical subtype and maternal age, using data from the prospective population-based survey of CP, the North of England Collaborative Cerebral Palsy Survey (NECCPS).
What is already known on this topic
While the prevalence of cerebral palsy (CP) for term infants has been stable over the last three decades, rates of CP in preterm and low birth weight infants increased in the 1980s and 1990s; since then decreasing rates are reported by most studies.
In North of England, rates of CP and more severe CP increased during 1964-1993, with the increases accounted for by low birth weight infants.
What this study adds
In the North of England between 1991-1995 and 1996-2000, there was no increase in either overall CP rate in singletons, in rates by any birth weight group or in rates of more severe CP by birth weight, gestational age or clinical groups.
For both preterm and term infants, the patterns of Z-score of birth weight-for-gestation are similar, with the CP rates increasing with deviations from the optimal weight for gestation at about 1 SD or more above the mean.
Methods
NECCPS uses the Little Club 10 definition of cerebral palsy, updated by Bax. 11 For this analysis, cases are those with congenital CP and include children who subsequently died. Cases of CP due to a known post-neonatal insult are excluded.
Study birth population
The Northern Region...