Waight E, McIntyre S, Woolfenden S, Goldsmith S, Reid S, Watson L, Britton P N, Webb A, Hansen M, Badawi N, Smithers-Sheedy H
Cerebral Palsy Alliance/Research Institute, Specialty of Child & Adolescent Health, The University of Sydney, Camperdown, Australia.
Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
J Paediatr Child Health. 2025 Mar;61(3):424-432. doi: 10.1111/jpc.16760. Epub 2025 Jan 2.
To describe the timing and causes of post-neonatally acquired cerebral palsy (PNN-CP) and map the implementation of relevant preventive strategies against cause-specific temporal trends in prevalence.
Data for a 1975-2014 birth cohort of children with PNN-CP (brain injury between 28 days and 2 years of age) were drawn from the Victorian and Western Australian CP Registers. Descriptive statistics were used to report causal events and timing. Poisson regression models were used to investigate the strength of evidence for cause-specific temporal trends in prevalence. Preventive strategies were mapped alongside cause-specific trends.
Amongst 512 children, causes of PNN-CP included infections (31%, n = 157), head injuries (24%, n = 121) and cerebrovascular accidents (CVAs) (23%, n = 119). Infections were the only main causal group of PNN-CP that declined significantly (p = 0.014). Fifty two percent (n = 267) of the PNN-CP cohort acquired their brain injury before 6 months of age, the majority having an infectious cause (57%, n = 90). Improved clinical care and a range of preventive strategies, including childhood vaccination programs, occurred during this period.
Infants under 6 months are a priority group for preventive strategies for PNN-CP. Declining temporal trends were observed for PNN-CP caused by infection, and the causal subgroup of CVAs associated with surgery. Interventions aimed at further reducing the risk of head injury, CVAs and infections, are needed to reduce the prevalence of PNN-CP.
描述新生儿期后获得性脑瘫（PNN-CP）的发生时间和原因，并针对特定病因的患病率时间趋势绘制相关预防策略的实施情况。
1975 - 2014年出生队列中患有PNN-CP（28天至2岁之间发生脑损伤）儿童的数据来自维多利亚州和西澳大利亚州脑瘫登记处。使用描述性统计报告因果事件和发生时间。采用泊松回归模型研究特定病因患病率时间趋势的证据强度。将预防策略与特定病因趋势一并绘制。
在512名儿童中，PNN-CP的病因包括感染（31%，n = 157）、头部损伤（24%，n = 121）和脑血管意外（CVA，23%，n = 119）。感染是PNN-CP唯一显著下降的主要病因组（p = 0.014）。52%（n = 267）的PNN-CP队列在6个月龄前发生脑损伤，大多数病因是感染（57%，n = 90）。在此期间，临床护理得到改善，还实施了一系列预防策略，包括儿童疫苗接种计划。
6个月以下婴儿是PNN-CP预防策略的重点人群。观察到感染导致的PNN-CP以及与手术相关的CVA病因亚组的时间趋势呈下降。需要采取旨在进一步降低头部损伤、CVA和感染风险的干预措施，以降低PNN-CP的患病率。
