Dhondt Evy, Dan Bernard, Plasschaert Frank, Degelaen Marc, Dielman Charlotte, Dispa Delphine, Ebetiuc Iulia, Hasaerts Danielle, Kenis Sandra, Lombardo Costanza, Pelc Karine, Wermenbol Vanessa, Ortibus Els
Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Inter-University Reference Centre for Cerebral Palsy (CIRICU), Inkendaal Rehabilitation Hospital, Vlezenbeek, Belgium; Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
Eur J Paediatr Neurol. 2023 Sep;46:8-23. doi: 10.1016/j.ejpn.2023.06.003. Epub 2023 Jun 14.
To report on the prevalence, neuroimaging patterns, and function of children with cerebral palsy (CP) in Belgium for birth years 2007-2012, and identify distinctive risk indicators and differences in outcome between CP subtypes.
Antenatal and perinatal/neonatal factors, motor and speech function, associated impairments, and neuroimaging patterns were extracted from the Belgian Cerebral Palsy Register. Prevalence was estimated per 1000 (overall, ante/perinatal, spastic, dyskinetic CP) or 10,000 (post-neonatal, ataxic CP) live births. Multinomial logistic regression analyses were performed to ascertain the effects of antenatal/perinatal/neonatal factors and neuroimaging patterns on the likelihood of dyskinetic or ataxic CP relative to spastic CP, and test the likelihood of the occurrence of impaired motor and speech function and associated impairments in dyskinetic or ataxic CP relative to spastic CP.
In total, 1127 children with CP were identified in Belgium. The birth prevalence of overall CP was 1.48 per 1000 live births. The likelihood of dyskinetic CP increases if the child was born to a mother aged ≥35 years, mechanically ventilated, and had predominant grey matter injury, while an increased likelihood of ataxic CP is associated with ≥2 previous deliveries. Children with dyskinetic and ataxic CP are more likely to function with impairments in motor, speech, and intellectual abilities.
Distinctive risk indicators and differences in outcome between CP subtypes were identified. These factors can be incorporated into clinical practice to facilitate early, accurate, and reliable classification of CP subtype, and may lead to individually tailored neonatal care and other (early) intervention options.
报告2007 - 2012年出生在比利时的脑瘫(CP)儿童的患病率、神经影像学模式及功能,并确定CP各亚型之间独特的风险指标及预后差异。
从比利时脑瘫登记处提取产前和围产期/新生儿期因素、运动和言语功能、相关损伤及神经影像学模式。按每1000例(总体、产前/围产期、痉挛型、运动障碍型CP)或10000例(新生儿期后、共济失调型CP)活产儿估算患病率。进行多项逻辑回归分析,以确定产前/围产期/新生儿期因素及神经影像学模式对运动障碍型或共济失调型CP相对于痉挛型CP发生可能性的影响,并测试运动障碍型或共济失调型CP相对于痉挛型CP出现运动和言语功能受损及相关损伤的可能性。
在比利时共识别出1127例CP儿童。CP的总体出生患病率为每1000例活产儿中有1.48例。如果孩子的母亲年龄≥35岁、接受机械通气且主要为灰质损伤,则运动障碍型CP的发生可能性增加,而共济失调型CP发生可能性增加与既往分娩≥2次有关。运动障碍型和共济失调型CP儿童在运动、言语和智力能力方面更易出现功能受损。
确定了CP各亚型之间独特的风险指标及预后差异。这些因素可纳入临床实践,以促进CP亚型的早期、准确和可靠分类,并可能带来个性化的新生儿护理及其他(早期)干预方案。