Temporal trends, clinical characteristics, and sociodemographic profile of post-neonatally acquired cerebral palsy in Australia, 1973-2012: A population-based observational study

Emma Waight; Sarah McIntyre; Susan Woolfenden; Linda Watson; Susan Reid; Heather Scott; Tanya Martin; Annabel Webb; Nadia Badawi; Hayley Smithers-Sheedy; Australian Cerebral Palsy Register Group

doi:10.1111/dmcn.15293

Temporal trends, clinical characteristics, and sociodemographic profile of post-neonatally acquired cerebral palsy in Australia, 1973-2012: A population-based observational study

Dev Med Child Neurol. 2023 Jan;65(1):107-116. doi: 10.1111/dmcn.15293. Epub 2022 Jun 5.

Affiliations

¹ Cerebral Palsy Alliance/Research Institute, Specialty of Child & Adolescent Health, The University of Sydney, Camperdown, NSW, Australia.
² Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.
³ Western Australian Register of Developmental Anomalies, Perth, WA, Australia.
⁴ Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
⁵ Women's and Children's Health Network, Adelaide, SA, Australia.
⁶ School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Australia.
⁷ Grace Centre for Newborn Care, The Children's Hospital at Westmead, Specialty of Child & Adolescent Health, The University of Sydney, Westmead, NSW, Australia.

Abstract

Aim: To describe post-neonatally acquired (PNN) cerebral palsy (CP) in terms of temporal trends in prevalence, clinical and sociodemographic profiles, known causes and associations between causes, and sociodemographic variables.

Method: Numerator data, a count of children with PNN-CP confirmed at 5 years of age (n = 523), was drawn from two Australian state CP registers (birth years 1973-2012). Poisson regression was used to investigate temporal trends in the prevalence of PNN-CP by 5-year intervals, calculated per 10 000 live births. Using data from all state and territory Australian CP registers (n = 469), distributions of clinical characteristics, PNN-CP causes, and sociodemographic factors were tabulated (birth years 1995-2012). χ² and logistic regression analyses were used to assess associations between sociodemographic profile, Australian reference data, and known causes.

Results: A significant temporal decline in PNN-CP in Victoria (p = 0.047) and Western Australia (p = 0.033) was observed. The most common proximal causes of PNN-CP were cerebrovascular accidents (34%, n = 158), infection (25%, n = 117), and non-accidental injuries (12%, n = 58). Children born to teenage mothers, Aboriginal and/or Torres Strait Islander mothers, or children born in remote areas were over-represented in this cohort compared with reference data (all p ≤ 0.001). Infectious causes were strongly associated with teenage motherhood (odds ratio 3.0 [95% confidence interval 1.1-8.2], p = 0.028) and remote living (odds ratio 4.5 [95% confidence interval 2.0-10.2], p < 0.001).

Interpretation: Although prevalence of PNN-CP has declined, the over-representation of priority populations, and the relative severity of a condition that is largely preventable, suggest the need for more specific primary preventive measures and support.

What this paper adds: Prevalence of post-neonatally acquired (PNN) cerebral palsy (CP) in Australia significantly declined between 1973 and 2012. Cerebrovascular accidents are the most common proximal cause of PNN-CP. Children born in remote areas are at greater risk of PNN-CP.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Cerebral Palsy* / epidemiology
Cerebral Palsy* / etiology
Child
Cohort Studies
Female
Humans
Prevalence
Stroke* / complications
Victoria / epidemiology