Cause-Specific Secular Trends and Prevention Measures of Post-Neonatally Acquired Cerebral Palsy in Victoria and Western Australia 1975-2014: A Population-Based Observational Study

E Waight; S McIntyre; S Woolfenden; S Goldsmith; S Reid; L Watson; P N Britton; A Webb; M Hansen; N Badawi; H Smithers-Sheedy

doi:10.1111/jpc.16760

Cause-Specific Secular Trends and Prevention Measures of Post-Neonatally Acquired Cerebral Palsy in Victoria and Western Australia 1975-2014: A Population-Based Observational Study

J Paediatr Child Health. 2025 Jan 2. doi: 10.1111/jpc.16760. Online ahead of print.

Authors

E Waight¹, S McIntyre¹, S Woolfenden², S Goldsmith¹, S Reid³, L Watson⁴, P N Britton⁵, A Webb¹, M Hansen^{4

6}, N Badawi^{1

7}, H Smithers-Sheedy¹

Affiliations

¹ Cerebral Palsy Alliance/Research Institute, Specialty of Child & Adolescent Health, The University of Sydney, Camperdown, Australia.
² Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
³ Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, Australia.
⁴ Western Australian Register of Developmental Anomalies, Perth, Australia.
⁵ Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead Sydney ID and Sydney Medical School, University of Sydney, Sydney, Australia.
⁶ The Kids Research Institute Australia, UWA Centre for Child Health Research, University of Western Australia, Perth, Australia.
⁷ Grace Centre for Newborn Care, The Children's Hospital at Westmead, Specialty of Child & Adolescent Health, The University of Sydney, Westmead, Australia.

PMID: 39748548
DOI: 10.1111/jpc.16760

Abstract

Aim: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: cerebral palsy; disability; epidemiology; prevention.

Abstract

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