Department of Obstetrics & Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.
Department of Health Systems and Sciences Research and Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, USA.
Nat Rev Neurol. 2018 Sep;14(9):528-543. doi: 10.1038/s41582-018-0043-6.
Cerebral palsy (CP) is the most prevalent, severe and costly motor disability of childhood. Consequently, CP is a public health priority for prevention, but its aetiology has proved complex. In this Review, we summarize the evidence for a decline in the birth prevalence of CP in some high-income nations, describe the epidemiological evidence for risk factors, such as preterm delivery and fetal growth restriction, genetics, pregnancy infection and other exposures, and discuss the success achieved so far in prevention through the use of magnesium sulfate in preterm labour and therapeutic hypothermia for birth-asphyxiated infants. We also consider the complexities of disentangling prenatal and perinatal influences, and of establishing subtypes of the disorder, with a view to accelerating the translation of evidence into the development of strategies for the prevention of CP.
脑瘫（CP）是儿童中最常见、最严重和最昂贵的运动障碍。因此，脑瘫是预防的重点公共卫生问题，但它的病因被证明很复杂。在这篇综述中，我们总结了一些高收入国家 CP 出生率下降的证据，描述了诸如早产和胎儿生长受限、遗传、妊娠感染和其他暴露等风险因素的流行病学证据，并讨论了通过在早产时使用硫酸镁和对窒息婴儿进行治疗性低温来预防脑瘫所取得的成功。我们还考虑了理清产前和围产期影响以及确定该疾病亚型的复杂性，以期加速将证据转化为预防脑瘫策略的发展。
