Pharoah P O, Cooke T, Johnson M A, King R, Mutch L
FSID Unit of Paediatric and Perinatal Epidemiology, University of Liverpool.
Arch Dis Child Fetal Neonatal Ed. 1998 Jul;79(1):F21-5. doi: 10.1136/fn.79.1.f21.
To report on the epidemiology of cerebral palsy in England and Scotland, to provide information on the prevalence of cerebral palsy and the severity of the disability or any co-morbidity.
Cerebral palsy registers were compiled from multiple sources of ascertainment covering all of Scotland and the counties of Merseyside, Cheshire, Berkshire, Buckinghamshire, Northamptonshire and Oxfordshire in England. All cases of cerebral palsy born in 1984 to 1989, to mothers resident in the area, were included. Denominator number of live births and neonatal deaths for determining birthweight specific prevalence were obtained from birth and death registrations. Learning, manual, and ambulatory disabilities were graded for severity. Any co-existing sensory (hearing or visual) morbidity was also graded for severity.
There were 789,411 live births in 1984-9, with 3651 neonatal deaths (neonatal mortality 4.6 per 1000 live births) and 1649 cases of cerebral palsy--a cerebral palsy prevalence of 2.1 per 1000 neonatal survivors. The birthweight specific cerebral palsy prevalence ranged from 1.1 per 1000 neonatal survivors in infants weighting > or = 2500 g to 78.1 in infants weighing < 1000 g. There was no significant time trend in prevalence of cerebral palsy in any of the birthweight groups, in contrast to the fall in neonatal mortality observed in all birthweight groups. Of the 1649 cases of cerebral palsy, 550 (33.4%) had severe ambulatory disability (no independent walking), 390 (23.7%) had severe manual disability (incapable of feeding or dressing unaided), 381 (23.1%) had severe learning disability (IQ < 50), 146 (8.9%) had severe visual disability (vision < 6/60 in the better eye) and 12 had severe hearing disability (> 70 dB loss).
Registers fill an important gap left by the lack of routine data on the prevalence of disability in children. The ability to record trends in the prevalence and the severity of the disability should inform those who have responsibility for providing services for children with disabilities.
报告英格兰和苏格兰脑瘫的流行病学情况，提供脑瘫患病率、残疾严重程度或任何合并症的相关信息。
脑瘫登记数据来自多个确诊来源，涵盖整个苏格兰以及英格兰的默西塞德郡、柴郡、伯克郡、白金汉郡、北安普敦郡和牛津郡。纳入了1984年至1989年在该地区居住的母亲所生的所有脑瘫病例。用于确定出生体重特异性患病率的活产数和新生儿死亡数的分母数据来自出生和死亡登记。对学习、手部操作和行走能力方面的残疾进行严重程度分级。对任何并存的感官（听力或视力）合并症也进行严重程度分级。
1984 - 1989年有789411例活产，3651例新生儿死亡（新生儿死亡率为每1000例活产4.6例），1649例脑瘫病例——脑瘫患病率为每1000例新生儿幸存者中2.1例。出生体重特异性脑瘫患病率范围从体重≥2500克的婴儿中每1000例新生儿幸存者中的1.1例到体重<1000克的婴儿中的78.1例。与所有出生体重组中观察到的新生儿死亡率下降相反，任何出生体重组中脑瘫患病率均无显著的时间趋势。在1649例脑瘫病例中，550例（33.4%）有严重行走能力残疾（无法独立行走），390例（23.7%）有严重手部操作残疾（无法独立进食或穿衣），381例（23.1%）有严重学习障碍（智商<50），146例（8.9%）有严重视力残疾（较好眼视力<6/60），12例有严重听力残疾（听力损失>70分贝）。
登记数据填补了儿童残疾患病率缺乏常规数据所留下的重要空白。记录患病率和残疾严重程度趋势的能力应为那些负责为残疾儿童提供服务的人员提供参考。
