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Prevalence Estimate of Cerebral Palsy in Northern Alberta: Births, 2008-2010

  • Charlene M.T. Robertson (a1), M. Florencia Ricci (a1), Kathleen O’Grady (a2), Maryam Oskoui (a3), Helly Goez (a1), Jerome Y. Yager (a1) and John C. Andersen (a1)...

Abstract

Objectives: The objectives of this study were to determine prevalence estimates of cerebral palsy (CP) among 5-year-old children in northern Alberta; to provide congenital, gestational age– and birth weight–specific, and postneonatal CP rates; and to describe motor subtypes and function. Methods: This population-based prevalence estimate study, part of the Canadian Cerebral Palsy Registry, reports confirmed CP diagnoses at age 5 years made by pediatric rehabilitation and child neurology specialists. Prevalence rates with 95% confidence intervals (CIs) used Alberta government denominators of same-age children and live births. Results: The Northern Alberta CP rate (birth years, 2008-2010) for 173 5-year-old children is 2.22 (95% CI 2.12, 2.32) per 1000 5-year-old children. The congenital CP rate is 1.99 (95% CI, 1.89-2.09) per 1000 live births; unilateral congenital CP, 1.0 (95% CI, 0.64-1.36) per 1000 live births; and postneonatal CP, 0.12 (95% CI, 0.1-0.14) per 1000 live births. Gestational age-specific rates are similar: age <28 weeks, 27.2 (95% CI, 23.05-31.35) and 28 to 31 weeks, 29.5 (95% CI, 25.78-33.22). Motor subtypes for 169 children (data missing, 4; male, 97; postnatal, 9) are: spastic, 148 (87.6%) including 31 (20.9%) with diplegia, 10 (6.8%) triplegia, 33 (22.2%) quadriplegia, 74 (50%) hemiplegia/monoplegia); and dyskinetic, 18 (10.6%) and ataxic, 3 (1.8%). A total of 107 (63.3%) ambulate without assistive devices and 111(65.7%) handle most objects with their hands independently. Conclusions: This is the fourth Canadian CP prevalence study; one from Quebec used a similar case ascertainment approach and two 1980s studies from Alberta and British Columbia used administrative databases. Northern Alberta CP rates are comparable with other developed countries. The hemiplegic subtype is the most common. Rates among preterm children have declined but are similar for the <28 and 28 to 31 gestation-week groups.

Estimations de la prévalence de la paralysie cérébrale chez les enfants du nord de l’Alberta nés entre 2008 et 2010. Objectifs: Cette étude s’est donné trois objectifs : estimer la prévalence de la paralysie cérébrale (PC) chez les enfants âgés de 5 ans du nord de l’Alberta ; faire connaître les taux de PC de nature congénitale et post-néonatale en plus de fournir des données au sujet de l’âge gestationnel; et décrire les divers troubles de la mobilité qui y sont associés ainsi que leurs caractéristiques. Méthodes: Cette étude visant à estimer la prévalence de la PC s’est appuyée sur le Registre canadien de paralysie cérébrale. Elle repose donc sur des diagnostics établis par des spécialistes en réadaptation pédiatrique et en neurologie infantile chez des enfants de 5 ans. Les taux de prévalence (IC 95%) reposent sur des données du gouvernement albertain ayant permis de déterminer le nombre de sujets du même âge et de naissances vivantes. Résultats: Le taux de PC chez les enfants du nord de l’Alberta nés entre 2008 et 2010, ce qui représente 173 sujets âgés de 5 ans, est de 2,22 (IC 95 % ; 2,12 - 2,32) par tranche de 1000 enfants âgés de 5 ans. Le taux de PC congénitale était de 1,99 (IC 95 % ; 1,89 - 2,09) par tranche de 1000 naissances vivantes. Le taux de PC congénitale unilatérale était de 1,0 (IC 95 % ; 0,64 -1,36) par tranche de 1000 naissances vivantes. Enfin, il était de 0,12 (IC 95 % ; 0,1 – 0,14) par tranche de 1000 naissances vivantes en ce qui concerne la PC post-néonatale. Soulignons que les taux de PC ne varient guère en fonction de l’âge gestationnel : âge < 28 semaines : 27,2 (IC 95 % ; 23,05 – 31,35) ; 28 à 31 semaines : 29,5 (IC 95 % ; 25,78 – 33,22). Sur un total de 169 enfants, les données étant incomplètes pour les 4 autres, on a pu identifier les troubles de la mobilité suivants: spastiques (148, soit 87,6 %), ce qui incluait 31 sujets atteints de diplégie (20,9 %), 10 de triplégie (6,8 %), 33 de quadriplégie (22,2 %) et 74 d’hémiplégie/monoplégie (50 %); dyskinétiques (18, soit 10,6 %) ; et ataxiques (3, soit 1,8 %). Fait à noter, 97 sujets étaient des garçons ; 9 sujets ont aussi vu leur trouble apparaître à la suite de leur naissance. Un total de 107 sujets (63,3 %) pouvaient se déplacer sans recourir à des appareils et à des accessoires fonctionnels tandis que 111 (65,7 %) étaient en mesure de manipuler de façon autonome des objets courants avec leurs mains. Conclusions: Notre étude constitue la quatrième étude canadienne portant sur la prévalence de la PC. Une étude menée au Québec avait utilisé la même approche de détermination de cas. Deux autres études, conduites dans les années 80 en Alberta et en Colombie-Britannique, avaient plutôt utilisé des bases de données administratives. Chose certaine, les taux de prévalence de la PC dans le nord de l’Alberta sont comparables à ceux des autres pays développés. Le trouble de la mobilité le plus répandu s’est avéré l’hémiplégie. Enfin, les taux de PC chez les enfants prématurés ont décliné ; ils demeurent néanmoins analogues dans le cas d’enfants dont l’âge gestationnel était inférieur à 28 semaines ou variait entre 28 et 31 semaines.

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Copyright

Corresponding author

Correspondence to: Charlene M. T. Robertson, Glenrose Rehabilitation Hospital, 10230-111th Ave, Edmonton, Alberta, Canada, T5G 0B7. Email: Charlene.robertson@ahs.ca

References

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1. Hirtz, D, Thurman, DJ, Gwinn-Hardy, K, Mohamed, M, Chaudhuri, AR, Zalutsky, R. How common are the ‘common’ neurological disorders? Neurology. 2007;68:326-337.
2. Rosenbaum, P, Paneth, N, Leviton, A, Goldstein, M, Bax, M. A report: the definition and classification of cerebral palsy. Dev Med Child Neurol. 2007;49(supp109):8-14.
3. Smithers-Sheedy, H, Badawi, N, Blair, E, et al. What constitutes cerebral palsy in the twenty-first century. Dev Med Child Neurol. 2014;56:323-328.
4. SCPE Collaborative Group. Surveillance of cerebral palsy in Europe; a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol. 2000;42:816-824.
5. McIntyre, S, Morgan, C, Walker, K, Novak, I. Cerebral palsy—don’t delay. Development Disabil Res Re. 2011;17:114-129.
6. Shevell, M, Dagenais, L, Oskoui, M. The epidemiology of cerebral palsy: new perspectives from A Canadian Registry. Semin Pediatr Neurol. 2013;20:60-64.
7. Oskoui, M, Coutinho, F, Dykaman, J, Jette, N, Pringsheim, T. An update on the prevalence of cerebral palsy: a systemic review and meta-analysis. Dev Med Child Neurol. 2013;55:509-519.
8. Odding, E, Roebroeck, ME, Stam, HJ. The epidemiology of cerebral palsy: incidence, impairments and risk factors. Disabil Rehabil. 2006;28:183-191.
9. Ravn, SH, Flachs, EM, Uldall, P. Cerebral palsy in eastern Denmark: declining birth prevalence but increasing numbers of unilateral cerebral palsy in birth year period 1986-1998. Eur J Paediatr Neurol. 2010;14:214-218.
10. Reid, SM, Meehan, E, McIntyre, S, Goldsmith, S, Badawi, N, Reddihough, DS. on behalf of the Australian Cerebral Palsy Register Group. Temporal trends in cerebral palsy by impairment severity and birth gestation. Dev Med Child Neurol. 2016;58(Supp 2):25-35.
11. Smithers-Sheedy, H, McIntyre, S, Gibson, C, et al. on behalf of the Australian Cerebral Palsy Register Group. A special supplement: findings from the Australian cerebral palsy Register, birth years 1993 to 2006. Dev Med Child Neurol. 2016;58(Supp 2):5-10.
12. Sellier, E, Platt, MJ, Andersen, GL, Krageloh-Mann, I, De La Cruz, J, Cans, C. on behalf of Surveillance of Cerebral Palsy Network. Decreasing prevalence in cerebral palsy: a multi-site European population-based study, 1980 to 2003. Dev Med Child Neurol. 2016;58:85-92.
13. Robertson, CMT, Watt, M-J, Yasui, Y. Changes in the prevalence of cerebral palsy in children born very prematurely within a population-based program over 30 years. JAMA. 2007;297:2733-2740.
14. Robertson, CMT, Svenson, LW, Joffres, MR. Prevalence of cerebral palsy in Alberta. Can J Neurol Sci. 1998;25:117-122.
15. Oskoui, M, Joseph, L, Dagenais, L, Shevell, M. Prevalence of cerebral palsy in Quebec: alternative approaches. Neuroepidemiology. 2013;40:264-268.
16. Government of Alberta. Interactive Health Data Application. Available at: http://www.ahw.gov.ab.ca/IHDA.
17. Male and female live births, birth weight by gestational period, 2008-2010. Edmonton, Alberta, Canada: Government Services, Alberta Vital Statistics, Annual Reviews, 2008-2010; Tables 4, 7, and 8.
18. Palisano, R, Rosenbaum, P, Walter, S, Russell, D, Wood, E, Galuppi, B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev med Child Neurol. 1997;39:214-223.
19. Eliasson, A-C, Krumlinde-Sundholm, L, Rosblad, B, et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006;48:549-554.
20. Harris, PA, Taylor, R, Thielke, R, Payne, J, Gonzalez, N, Conde, JG. Research electronic data capture (REDCap) – A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377-381.
21. Blair, E, Watson, L. Epidemiology of cerebral palsy. Semin Fetal Neonatal Med. 2006;11:117-125.
22. Himpens, E, Van den Broeck, C, Oostra, A, Calders, P, Vanhaesebrouck, P. Prevalence, type, distribution, and severity of cerebral palsy in relation to gestational age: a meta-analytic review. Dev Med Child Neurol. 2008;50:334-340.
23. Germany, L, Ehlinger, V, Klapouszczak, D, et al. Trends in prevalence and characteristics of post-neonatal cerebral palsy cases: a European registry-based study. Res Development Disabi. 2013;34:1669-1677.
24. Reid, S, Carlin, JB, Reddihough, D. Distribution of motor types in cerebral palsy: how do registry data compare. Dev Med Child Neurol. 2011;53:233-238.
25. Golomb, MR, Garg, BP, Saha, C, Azzouz, F, Williams, LS. Cerebral palsy after perinatal ischemic stroke. J Child Neurol. 2008;23:279-286.
26. Shevell, MI, Dagenais, l, Hall, N. The relationship of cerebral palsy subtype and functional motor impairment: a population-based study. Dev Med Child Neurol. 2009;51:872-877.
27. Smith, L, Kelly, KD, Prkachin, G, Voaklander, DC. The prevalence of cerebral palsy in British Columbia, 1991-1995. Can J Neurol Sci. 2008;35:342-347.

Keywords

Prevalence Estimate of Cerebral Palsy in Northern Alberta: Births, 2008-2010

  • Charlene M.T. Robertson (a1), M. Florencia Ricci (a1), Kathleen O’Grady (a2), Maryam Oskoui (a3), Helly Goez (a1), Jerome Y. Yager (a1) and John C. Andersen (a1)...

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