Prevalence of and risk factors for cerebral palsy in a total population cohort of low-birthweight (less than 2000g) infants.

This paper reports a total population-based cohort study of over 500 surviving children born in 1974, 1975 and 1976, who were identified as having been a low birthweight (less than 200g). The prevalence of cerebral palsy (CP) diagnosed by age six years was compared for groups who had various antenatal and perinatal attributes. For children who had weighed less than 2000g the CP prevalence was 3.6 per cent for those less than 1500g and 4.3 per cent for those between 1500g and 1999g. The main factors predicting CP in the low-birthweight infants were measures of neonatal asphyxia, but the majority of children with CP had no extra adverse perinatal risk-factors compared to non-CP survivors, were not asphyxiated and had not received high-level neonatal intensive care. The CP rates were not significantly different between any other available antenatal, perinatal or sociodemographic risk-factor groups. It is suggested, therefore, that CP is not a good index of the impact of neonatal intensive care, and that research should now concentrate on elucidating the genetic, developmental and antenatal risk-factors for the various CP syndromes.