Congenital anomalies in children with cerebral palsy: a population-based record linkage study

Authors


  • ACKNOWLEDGEMENTS
    This study was supported by a grant from La Foundation Motrice. SCPE is funded by DG Sanco contract no. 2003131 and EUROCAT is co-funded by the DG Sanco Public Health Programme. We are grateful to all the link clinicians in the Northern Region for their continued collaboration and support of the NECCPS and the NorCAS. We thank Mary Bythell, NECCPS/ NorCAS data manager. NorCAS is funded by the Department of Health Policy Research Programme (Disease Register). JR is funded by a Personal Award Scheme Career Scientist Award from the National Institute of Health Research (Department of Health). We are grateful to the Danish Spastic Society for supporting this study. REMERA and RHEOP acknowledge the Conseil Regional Rhône-Alpes, le Conseil Général de l’Isère, l’Institut National de Veille Sanitaire, l’Institut National de la Santé et de la Recherche Médicale, as well as all their public and private sources of ascertainment.

  • Correction was added on 20 October 2009: one of the authors' names has been amended.

Dr Judith Rankin at Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4HH, UK. E-mail: j.m.rankin@ncl.ac.uk

Abstract

Aim  Our aim was to determine the proportion of children with cerebral palsy (CP) who have a congenital anomaly (CA) in three regions (Isère Region, French Alps; Funen County, Denmark; Northern Region, England) where population-based CP and CA registries exist, and to classify the children according to CA subtype.

Method  Data for children born between 1991 and 1999 were linked using electronic matching of cases. All potential matches were checked manually by each centre and verified as true matches.

Results  A total of 1104 children with CP were born during the study period (663 males, 441 females). Of these, 166 (15%; 95% Confidence Interval [CI] 13.0–17.3) children with CP had a CA: 8.8% had a cerebral anomaly, 4.8% had a non-cerebral anomaly, and 1.4% had a non-cerebral-related syndrome or a chromosomal/genetic anomaly.

Interpretation  The prevalence of cerebral anomaly was highest in children with ataxic CP (41.7%) and lowest in those with dyskinetic CP (2.1%). Cerebral anomalies were found in 8.4% and 7% of children with bilateral and unilateral spastic CP respectively. The most frequent cerebral anomalies were primary microcephaly (26.5%) and congenital hydrocephalus (17.3%). The most common non-cerebral anomalies recorded were cardiac (12.6% of children with CP and CA), urinary (5.4%), and musculoskeletal (5.4%). The prevalence of cerebral anomalies was higher among children born at term (13%) than among those born preterm (3.8%). Associated sensorineural or intellectual impairments occurred more often in children with CP and cerebral anomalies. We concluded that cerebral and non-cerebral CA prevalence was higher among the CP population than in the general population of live births.

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