Declining prevalence of cerebral palsy in children born at term in Denmark

Aim To investigate reasons for the declining prevalence of cerebral palsy (CP) in children born at term in Denmark by evaluating obstetric and neonatal factors associated with CP, and their changes over time. Method In this cohort study, we included 987 495 children (504 600 [51.1%] males and 482 89...

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Published in:Developmental medicine and child neurology 2022-06, Vol.64 (6), p.715-722
Main Authors: Larsen, Mads L., Rackauskaite, Gija, Greisen, Gorm, Laursen, Bjarne, Uldall, Peter, Krebs, Lone, Hoei‐Hansen, Christina E.
Format: Article
Language:English
Subjects:
Cerebral Palsy - epidemiology
Cerebral Palsy - etiology
Child
Cohort Studies
Denmark - epidemiology
Female
Gestational Age
Humans
Infant, Newborn
Male
Pregnancy
Prevalence
Risk Factors
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Summary:Aim To investigate reasons for the declining prevalence of cerebral palsy (CP) in children born at term in Denmark by evaluating obstetric and neonatal factors associated with CP, and their changes over time. Method In this cohort study, we included 987 495 children (504 600 [51.1%] males and 482 895 [48.9%] females) born after 37 completed gestational weeks during birth years 1997 to 2013. Risk ratios of CP for each factor were calculated with log‐binominal regression analyses. Significant factors were evaluated concerning their development in prevalence over time. Results In the antenatal period, there were significant associations with an increased risk of CP and high maternal body mass index (BMI), smoking during pregnancy, nulliparity, male sex, gestational age, and low birthweight. In the study period, fewer females smoked during pregnancy and fewer children were born post‐term, dropping from 22.6% to 11.4% and 9.4% to 2.5% respectively. Conversely, the proportion of females with high BMI increased. Most significant risk factors were found in the neonatal period, with an increase in children with diagnosed birth defects and children admitted to neonatal care. Interpretation Reasons for the declining prevalence of CP appear to be multifactorial and likely include the decline in maternal smoking and children born post‐term along with centralization and advances in neonatal treatment. Video Podcast: https://youtu.be/vzgiD8bfImc
ISSN:0012-1622
1469-8749
DOI:10.1111/dmcn.15136