Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
Dev Med Child Neurol. 2011 Oct;53(10):907-12. doi: 10.1111/j.1469-8749.2011.04039.x. Epub 2011 Jul 14.
The aim of this study was to assess overall and gestational age-specific trends in the rate of cerebral palsy (CP) in Victoria, Australia, and to compare these findings with other population data.
Individuals born in Victoria from 1970 to 2004 with non-postneonatally acquired CP were identified from a population register; 3491 were included in the study (1963 males, 1528 females). After a literature review, comparison data were extracted from publications using previously devised inclusion criteria. Rates were calculated per 1000 live births for all CP and by gestational age group: these were tabulated and plotted by year of birth.
Data from nine registries, including the Victorian register, showed an increase in the rates of CP over the 1970s and 1980s, consistently seen in extremely preterm (<28 wks) survivors but also in those born at term (≥37 wks). Since the early 1990s, CP rates either stabilized or decreased, particularly for children born extremely preterm.
Increases in the rates of CP during the 1970s and 1980s are in part because of the increasing survival of extremely preterm infants that occurred without a concomitant improvement in neurological outcomes. Evidence from population samples now suggests that this trend has been reversed since the mid- to late 1990s.
本研究旨在评估澳大利亚维多利亚州脑瘫（CP）的总体和胎龄特异性发生率趋势，并将这些发现与其他人群数据进行比较。
从人口登记册中确定了 1970 年至 2004 年期间在维多利亚州出生的非新生儿获得性 CP 患者；共有 3491 例患者纳入研究（男性 1963 例，女性 1528 例）。在文献回顾之后，使用先前制定的纳入标准从出版物中提取了比较数据。所有 CP 的发生率按每 1000 例活产计算，并按胎龄组进行分组：这些数据按出生年份进行列表和绘图。
来自九个登记处的数据，包括维多利亚州的登记处，显示出 1970 年代和 1980 年代 CP 发生率的增加，在极早产儿（<28 周）幸存者中一直持续存在，但在足月儿（≥37 周）中也存在这种情况。自 20 世纪 90 年代初以来，CP 发生率要么稳定，要么下降，尤其是对于极早产儿而言。
1970 年代和 1980 年代 CP 发生率的增加部分是由于极早产儿的存活率增加所致，而这并没有伴随神经发育结局的改善。来自人群样本的证据表明，自 20 世纪 90 年代中期以来，这种趋势已经逆转。
