Hagberg B, Hagberg G, Olow I
Acta Paediatr Scand. 1984 Jul;73(4):433-40. doi: 10.1111/j.1651-2227.1984.tb09951.x.
From a population-based series of 773 patients with cerebral palsy (CP) born in 1959-78, an analysis was made of the epidemiological trends over this period of 20 years, divided into five 4-year periods with emphasis on the last two. After a significantly decreasing incidence of CP in the first three periods (1959-70) from 1.9 to 1.4 per thousand, there was a significant increase in the last two periods, reaching 2.0 per thousand in the period 1975-78. Both the decreasing trend in the earlier periods and the increasing trend in the more recent ones were mainly referrable to spastic/ataxic diplegia in preterm CP, and to dyskinetic syndromes in CP infants born at term. With respect to pathogenesis, the corresponding changes in CP incidence were mainly accounted for by the group with potential perinatal risk factors. When analysed on the basis of surviving babies in birth-weight-specific groups, the incidence of CP in 1971-78 was found to have increased in all groups, but this was only statistically significant in the low birth weight group of 2 000-2 500 g. Changing trends in incidences ran parallel with a steadily progressive decline in perinatal mortality through all five periods. A considerable and cumulative net gain of surviving non-CP children was continuously achieved; this was also true for 1970-78, in spite of an increasing CP morbidity during these last two 4-year periods.
对1959年至1978年出生的773例脑瘫（CP）患者的人群队列进行分析，研究这20年期间的流行病学趋势，分为五个4年时间段，重点关注最后两个时间段。在前三个时间段（1959 - 1970年），脑瘫发病率显著下降，从千分之一降至千分之一点四，而在最后两个时间段则显著上升，在1975 - 1978年期间达到千分之二。早期的下降趋势和近期的上升趋势主要分别归因于早产脑瘫中的痉挛/共济失调双瘫，以及足月儿脑瘫中的运动障碍综合征。关于发病机制，脑瘫发病率的相应变化主要由具有潜在围产期危险因素的人群导致。按出生体重特定组别的存活婴儿进行分析时，发现1971 - 1978年期间所有组别的脑瘫发病率均有所上升，但仅在2000 - 2500克的低出生体重组中具有统计学意义。在所有五个时间段中，发病率的变化趋势与围产期死亡率的稳步下降平行。非脑瘫存活儿童持续实现了可观的累积净增长；1970 - 1978年期间也是如此，尽管在这最后两个4年时间段内脑瘫发病率有所上升。
