Global prevalence of cerebral palsy: A systematic analysis

Sarah McIntyre, Shona Goldsmith, Annabel Webb, Virginie Ehlinger, Sandra Julsen Hollung, Karen Mc Connell, Catherine Arnaud, Hayley Smithers-Sheedy, Maryam Oskoui, Gulam Khandaker, Kate Himmelmann

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Abstract

Aim To determine trends and current estimates in regional and global prevalence of cerebral palsy (CP). 

Method A systematic analysis of data from participating CP registers/surveillance systems and population-based prevalence studies (from birth year 1995) was performed. Quality and risk of bias were assessed for both data sources. Analyses were conducted for pre-/perinatal, postnatal, neonatal, and overall CP. For each region, trends were statistically classified as increasing, decreasing, heterogeneous, or no change, and most recent prevalence estimates with 95% confidence intervals (CI) were calculated. Meta-analyses were conducted to determine current birth prevalence estimates (from birth year 2010). 

Results Forty-one regions from 27 countries across five continents were represented. Pre-/perinatal birth prevalence declined significantly across Europe and Australia (11 out of 14 regions), with no change in postneonatal CP. From the limited but increasing data available from regions in low- and middle-income countries (LMICs), birth prevalence for pre-/perinatal CP was as high as 3.4 per 1000 (95% CI 3.0–3.9) live births. Following meta-analyses, birth prevalence for pre-/perinatal CP in regions from high-income countries (HICs) was 1.5 per 1000 (95% CI 1.4–1.6) live births, and 1.6 per 1000 (95% CI 1.5–1.7) live births when postneonatal CP was included. 

Interpretation The birth prevalence estimate of CP in HICs declined to 1.6 per 1000 live births. Data available from LMICs indicated markedly higher birth prevalence. 

What this paper adds 

• Birth prevalence of pre-/perinatal cerebral palsy (CP) in high-income countries (HICs) is decreasing. 

• Current overall CP birth prevalence for HICs is 1.6 per 1000 live births. 

• Trends in low- and middle-income countries (LMICs) cannot currently be measured. 

• Current birth prevalence in LMICs is markedly higher than in HICs. 

• Active surveillance of CP helps to assess the impact of medical advancements and social/economic development. 

• Population-based data on prevalence and trends of CP are critical to inform policy.

This paper determined the current birth prevalence of cerebral palsy in high-income countries has declined to 1.6/1000 live births. Birth prevalence for low- and middle-income countries is markedly higher.

Original languageEnglish
Pages (from-to)1494-1506
Number of pages13
JournalDevelopmental Medicine and Child Neurology
Volume64
Issue number12
Early online date11 Aug 2022
DOIs
Publication statusPublished (in print/issue) - Dec 2022

Bibliographical note

Funding Information:
The Australian CP Register and the NSW/ACT CP Register are funded by the Cerebral Palsy Alliance, Australia. The Northern Ireland Cerebral Palsy Register is funded by the Public Health Agency Northern Ireland. The Norwegian Quality and Surveillance Registry for Cerebral Palsy is funded by the South‐Eastern Norway Regional Health Authority. The Registry of Childhood Disabilities in Haute‐Garonne county (RHE31), France, is funded by the Public Health Agency France and the National Institute of Health and Medical Research. Registre des Handicaps de l'Enfant et Observatoire Périnatal, Grenoble, France.

Publisher Copyright:
© 2022 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Keywords

  • cerebral palsy
  • prevalence
  • systematic analysis

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