Suzuki Junko, Ito Masatoshi
Department of Preschool Education, Shiga Women's Junior College, 24-4 Tatsugaoka, Otsu, Shiga 520-0803, Japan.
Brain Dev. 2002 Jan;24(1):39-48. doi: 10.1016/s0387-7604(01)00395-3.
The prevalence of cerebral palsy (CP) in 6-year-old children in Shiga Prefecture, Japan, born between 1977 and 1991, was compared in three successive 5-year periods: period I (1977-1981), period II (1982-1986) and period III (1987-1991). Data on the accumulated age-specific prevalence of CP were collected and analyzed. During the study period, 242293 children entered elementary school, and 325 cases (194 boys, 131 girls) of CP were ascertained in Shiga Prefecture. The overall prevalence of CP per 1000 6-year-old children was 1.34. The prevalence of CP for 6-year-old children increased from period II to period III, although it did not vary from period I to period II. The proportion of low birth weight (LBW) infants and preterm infants among those with CP increased with time during the study periods. The prevalence of CP in infants born at term and with birth weight > or =2500 g did not vary over the study period. The prevalence of CP in preterm and LBW infants, especially in infants with gestational age<32 weeks and birth weight<1500 g, increased from period II to period III, while the prevalence did not increase from period I to period II. Multiple births and use of mechanical ventilation increased from period II to period III. The changes in the prevalence of CP in Shiga Prefecture may have been due to increased survival of preterm and LBW infants in period II owing to better obstetric and neonatal care, and to further improvement in the survival of very small babies receiving intensive care, which increased the prevalence of CP in period III. Further improvement of perinatal care might decrease the incidence of CP in Shiga Prefecture in the future.
对日本滋贺县1977年至1991年期间出生的6岁儿童脑瘫（CP）患病率进行了比较，分为连续三个5年时间段：第一阶段（1977 - 1981年）、第二阶段（1982 - 1986年）和第三阶段（1987 - 1991年）。收集并分析了按年龄累积的CP患病率数据。在研究期间，滋贺县有242293名儿童进入小学，确诊为CP的有325例（194名男孩，131名女孩）。每1000名6岁儿童中CP的总体患病率为1.34。6岁儿童的CP患病率从第二阶段到第三阶段有所增加，尽管从第一阶段到第二阶段没有变化。在研究期间，CP患儿中低出生体重（LBW）婴儿和早产儿的比例随时间增加。足月出生且出生体重≥2500g的婴儿CP患病率在研究期间没有变化。早产和低出生体重婴儿，尤其是孕周<32周且出生体重<1500g的婴儿，CP患病率从第二阶段到第三阶段有所增加，而从第一阶段到第二阶段患病率没有增加。多胞胎和机械通气的使用从第二阶段到第三阶段有所增加。滋贺县CP患病率的变化可能是由于第二阶段产科和新生儿护理改善，早产和低出生体重婴儿存活率增加，以及第三阶段接受重症监护的极小婴儿存活率进一步提高，从而增加了CP患病率。未来围产期护理的进一步改善可能会降低滋贺县CP的发病率。
