Decrease may be attributable to a reduction in severe cystic periventricular leukomalacia
MONDAY, March 7 (HealthDay News) -- The incidence and severity of cerebral palsy (CP) among preterm survivors decreased significantly from 1990 to 1993 onward, possibly because of a reduction in severe cystic periventricular leukomalacia (c-PVL), according to a study published online March 3 in The Journal of Pediatrics.
Ingrid C. van Haastert, of the Wilhelmina Children's Hospital/University Medical Center in Utrecht, Netherlands, and colleagues evaluated the incidence and severity of CP and associated factors among preterm survivors (gestational age, <34 weeks) admitted to a neonatal intensive care unit between 1990 and 2005. The investigators divided the cohort into four birth periods: 1990 to 1993 (period I), 1994 to 1997 (period II), 1998 to 2001 (period III), and 2002 to 2005 (period IV).
The investigators found that the incidence of CP decreased from 6.5 percent in period I to 2.6 percent in period II, 2.9 percent in period III, and 2.2 percent in period IV. In addition, c-PVL decreased from 3.3 percent in period I to 1.3 percent in period IV, with c-PVL grade III decreasing from 2.3 percent in period I to 0.2 percent in period IV. The investigators also found that the number of children with Gross Motor Function Classification System (GMFCS) levels III-V decreased from period I to IV. While c-PVL and severe intraventricular hemorrhage were independent risk factors for CP, antenatal antibiotics, presence of an arterial line, cesarean section, and gestational age were independent protective factors.
"Coinciding with increasing rates of survival from 1990 to 2005 in our hospital-based cohort of infants born preterm, CP incidence decreased significantly since 1990 to 1993 and was stable thereafter. Simultaneously, a reduction in the number of children with severe gross motor functional limitations, as expressed by GMFCS levels III-V, was seen over time," the authors write.