The incidence and implications of cerebral palsy following potentially avoidable obstetric complications: a preliminary burden of disease study
Article first published online: 3 JUN 2014
© 2014 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 121, Issue 13, pages 1720–1728, December 2014
How to Cite
The incidence and implications of cerebral palsy following potentially avoidable obstetric complications: a preliminary burden of disease study. BJOG 2014;121:1720–1728., , , , , .
- Issue published online: 21 NOV 2014
- Article first published online: 3 JUN 2014
- Manuscript Accepted: 23 APR 2014
- Advanced Life Support Group of Swinton
- Cerebral palsy;
- health economics;
- intrapartum care
To determine the extent of cerebral palsy attributable to adverse obstetric events, and estimate the lifetime mortality and morbidity expectations of these individuals relative to age-matched members of the UK general population.
All projected live births during 2014.
Using published data regarding the incidence and aetiology of cerebral palsy, we simulated the outcomes of a hypothetical cohort of UK live births. Survival and quality of life (QoL) for those with cerebral palsy were compared with age-matched individuals representative of the UK general population, in order to estimate the number of quality-adjusted life years (QALYs) lost following asphyxia-related cerebral palsy.
Main outcome measures
Incidence of asphyxia-related cerebral palsy, QALYS, QoL, and survival.
A total of 207 (95% CI 169–245) cases of asphyxia-related cerebral palsy were projected amongst UK children born during the year 2014, with approximately 15.2 QALYs lost per case. If these results held true in a real birth cohort, 3142 (95% CI 2321–3963) QALYs would be lost as a consequence of asphyxia-related cerebral palsy, a loss valued by the UK National Health Service at £62.9 m (95% CI £46.4–79.3 m).
Cerebral palsy following intrapartum asphyxiation leads to significant reductions in QoL and survival; however, this may often be prevented. For those with GMFCS 1 and GMFCS 2 cerebral palsy (Gross Motor Function Classification System), lifetime QALYs accrued largely resemble those experienced by the UK general population, whereas for GMFCS 3 and GMFCS 4 QALYs are reduced considerably, and are negative in the case of GMFCS 5.