Prevalence and Initial Diagnosis of Cerebral Palsy in Preterm and Term-Born Children in Taiwan: A Nationwide, Population-Based Cohort Study

Hsin-Hua Wang, Yea-Shwu Hwang, Chung-Han Ho, Ming-Chi Lai, Yu-Chin Chen and Wen-Hui Tsai
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Hsin-Hua Wang: Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan
Yea-Shwu Hwang: Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
Chung-Han Ho: Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan
Ming-Chi Lai: Division of Pediatric Neurology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan
Yu-Chin Chen: Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan
Wen-Hui Tsai: Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan

IJERPH, 2021, vol. 18, issue 17, 1-11

Abstract: The aim of this long-term longitudinal study in Taiwan was to estimate and compare the prevalence of cerebral palsy (CP) and to identify the age of CP diagnosis of term-born and preterm children with different birthweights. Records of 1494 extremely low birth weight (ELBW, <1000 g), 3961 very low birth weight (VLBW, 1000–1499 g), 19,612 low birth weight (LBW, 1500–2499 g) preterm, and 100,268 matched term-born children were retrieved from Taiwan?s National Health Insurance Research Database. According to a 12-year retrospective data review, the results showed the highest prevalence of CP in preterm ELBW children (147.3 cases per 1000 neonatal survivors), followed by preterm VLBW (97.2 cases), preterm LBW (27.7 cases), with the lowest prevalence in term-born children (2.5 cases). Regardless of the birthweight group, 90% of preterm children with CP were diagnosed by 4 years of age, but it was 7 years before 90% of term-born children with CP were diagnosed. After removing the children whose CP was caused by brain infections, injuries, or cerebrovascular accidents after 4 months of age, there were similar mean ages at the initial CP diagnosis (1.58–1.64 years of age) across birthweight groups born prematurely, but initial diagnosis occurred at an older age (2.41 years of age) in term-born children. The results indicate that birthweight is reversely correlated with the prevalence of CP in preterm children. Although the three preterm birthweight groups received different types of developmental follow-up programs after birth, it did not influence their age at the initial diagnosis of CP. Furthermore, we suggest that follow-up for at least 4 years after birth for preterm children, and 7 years for term-born children, is optimal for estimating CP prevalence. In order to identify and provide early intervention for term-born children with CP earlier, it is suggested that parents routinely fill out a self-reported motor developmental screening questionnaire and pediatricians conduct a motor developmental examination on term-born children at each time of scheduled vaccination injections.

Keywords: preterm; cerebral palsy; prevalence; diagnosis; low birth weight (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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