Himpens E, Van den Broeck C, Oostra A, Calders P, Vanhaesebrouck P
Rehabilitation Sciences and Physiotherapy Ghent, Artevelde University College - Ghent University, Ghent, Belgium.
Dev Med Child Neurol. 2008 May;50(5):334-40. doi: 10.1111/j.1469-8749.2008.02047.x. Epub 2008 Mar 18.
The aim of this review is to determine the relationship between gestational age (GA) and prevalence, type, distribution, and severity of cerebral palsy (CP). Epidemiological studies with cohorts expressed by GA were assessed. A comprehensive meta-analysis and meta-regression was performed on four fetal age categories. Studies of children with CP as a target population were added. Twenty-six articles met the inclusion criteria. The prevalence of CP decreases significantly with increasing GA category: 14.6% at 22 to 27 weeks' gestation, 6.2% at 28 to 31 weeks, 0.7% at 32 to 36 weeks, and 0.1% in term infants. Interestingly, a significant decrease in prevalence of CP starts only from a GA of 27 weeks onwards. In preterm infants, spastic CP is predominant. In term infants, the non-spastic form of CP is more prevalent than in preterm infants. Bilateral spastic CP is most prevalent in both preterm and term infants. However, the proportion of unilateral spastic CP in term infants is substantial. No relationship could be detected between severity of CP and GA. There is a strong need for an international, well-described, and generally accepted classification system for subtypes and severity of CP.
本综述的目的是确定胎龄（GA）与脑瘫（CP）的患病率、类型、分布及严重程度之间的关系。对以GA表示队列的流行病学研究进行了评估。针对四个胎龄类别进行了全面的荟萃分析和荟萃回归。还纳入了以CP患儿为目标人群的研究。26篇文章符合纳入标准。CP的患病率随GA类别增加而显著降低：妊娠22至27周时为14.6%，28至31周时为6.2%，32至36周时为0.7%，足月儿为0.1%。有趣的是，CP患病率的显著下降仅从27周的胎龄开始。在早产儿中，痉挛型CP占主导。在足月儿中，非痉挛型CP比早产儿更普遍。双侧痉挛型CP在早产儿和足月儿中最为常见。然而，足月儿中单侧痉挛型CP的比例也相当大。未发现CP严重程度与GA之间存在关联。迫切需要一个国际上统一的、描述详尽且被广泛接受的CP亚型和严重程度分类系统。
