McMaster University

McMaster University

Cerebral palsy cases have dropped

By Shari Roan
Los Angeles Times
March 3, 2011

Cerebral palsy is a common complication of very premature birth. The condition is a type of brain injury that causes problems with motor function. It's been a baffling disorder for doctors because of confusion over what causes the brain injury.

Doctors still don't know what surefire steps to take to prevent the condition. However, a study published Thursday suggests that general improvements in the care of infants just before, during and after delivery are making a difference. Researchers in the Netherlands studied almost 3,000 infants born prematurely between 1990 and 2005. Cerebral palsy rates declined 6.5% from the start of that period compared with the years from 2002-05. The study also found a decrease in the severity of cases. The decreases in cases and severity were mostly due to a significant decline in injuries called white matter lesions in the brain. Studies in other populations have detected reductions, too, in recent years, including the United States and Canada.

Various strategies have been tested to lower cerebral palsy rates, such as Cesarean section delivery, fetal monitoring and various medications, such as antibiotics and corticosteroids. Still, it's not clear why the prevalence of white matter lesions that cause cerebral palsy is falling, said an  author of the study, Linda de Vries, of the University Medical Center Utrecht. It seems that overall care of infants is just better.

"There is not really a single factor we can point out," De Vries said. "It is more general improved perinatal care ... It was striking that an illness severity score came down significantly. Improved perinatal care, in general, is the best answer to both factors."

The study is published in the Journal of Pediatrics.


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