An international team of researchers, led by Australia’s Cerebral Palsy Alliance Research Institute, found the prevalence of cerebral palsy has fallen by 25% in Australia and Europe.
The landmark paper, published in the medical journal, Developmental Medicine & Child Neurology, establishes that the number of children born with cerebral palsy is steadily falling across many high-income countries globally.
Titled ‘Global prevalence of cerebral palsy: a systemic analysis’, the paper is the first global academic study of cerebral palsy trends in a decade, surveying international data from birth years 1995-2014.
Using population-level data collected from more than 40 regions across 27 countries, researchers have discovered that the rate of cerebral palsy has fallen steadily in Australia and Europe over the last decade, to a rate of 1.6 babies out of every 1,000 children born.
The new figure marks a 25% reduction in rates of cerebral palsy across high income countries from the last international study of cerebral palsy prevalence, which was published in 2013 and established a rate of CP of 2.1/1,000 live births.
The most common physical disability in childhood, cerebral palsy is a life-long condition affecting at least 34,000 people in Australia and more than 17 million people worldwide. There is no known cure for the condition, which affects movement and posture and is most often caused by a brain injury during pregnancy or shortly after birth.
"These findings are a good news story, and a result of researchers, policy makers, health professionals and families all working together"
Despite being the most common physical disability in childhood, historically little was known about how cerebral palsy was caused until data from CP registers gave researchers new tools to identify the causal pathways linked to CP.
Lead author Dr Sarah McIntyre said the study will give medical professionals, clinicians and researchers a valuable new understanding of cerebral palsy and the impact of constant improvements in pregnancy and newborn care across high income countries.
“These findings are a good news story, and a result of researchers, policy makers, health professionals and families all working together”, said Dr McIntyre, Senior Research Fellow at the Cerebral Palsy Alliance Research Institute Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia.
“CP registers are a way to measure recent advances in care of pregnant women and babies. These big data sets allow researchers to report back to all those working hard in the public health and hospital systems. Every single pregnant woman and family being assessed regularly and treated carefully with best available evidence, adds up. Now at a population level, we are seeing these substantial declines.”
Additionally, researchers have established a baseline rate of cerebral palsy in low-and-middle-income countries (LMICs) of 3-4/1000 live births, at least double that of high-income countries.
While a recent expansion of CP surveillance data has enabled the researchers to calculate rates of CP in some LMICs, it is likely this figure significantly underestimates the true rate of CP due to higher infant and childhood mortality, and the difficulty in establishing mild cases of CP in the community.
Supporting cerebral palsy registers in LMIC countries is a strategic priority for Cerebral Palsy Alliance, which has provided $3.7 million in funding to research projects in 28 nations since 2012. CPA researchers are actively involved in supporting CP registers in countries such as Bangladesh, Sri Lanka, Vietnam, Indonesia, Nepal and Ghana.
"Not only does this positively impact people and the healthcare systems of high-income countries, but it provides hope that incidence of CP could also be reduced in low- and middle-income countries as well"
Dr McIntyre said that a benchmark rate in LMIC regions is of vital importance, as researchers anticipate that the rate of CP in LMICs will actually rise as advances in newborn care in these countries lead to higher survival rates of pre-term births and critically ill babies.
Natasha Garrity, a research assistant trainee at Cerebral Palsy Alliance Research Institute who has cerebral palsy and is a member of the Global CP Prevalence Group that authored the paper, said the results are meaningful for the global disability community.
“This is an amazing result for the whole CP community. Not only does this positively impact people and the healthcare systems of high-income countries, but it provides hope that incidence of CP could also be reduced in low- and middle-income countries as well. Our big challenge is to work out how we can best support these countries to do it!”
The registers analysis was conducted by a multi-disciplinary team of collaborators from Sydney’s Cerebral Palsy Alliance Research Institute, the Center for Epidemiology and Research in Population Health (Toulouse, France), the Norwegian Quality and Surveillance Registry for Cerebral Palsy, Ulster University’s School of Health Sciences Ireland, the Central Queensland Hospital and Health Service, McGill University in Canada and the Department of Pediatrics at the University of Gothenburg in Sweden.