Incidence and Prevalence of Cerebral Palsy
Risk Factors and Associated Symptoms
According to the CDC, cerebral palsy (CP) is the most common disabilities in childhood that affect muscles and motor function. The prevalence ranges from 1.5 to 4 cases per 1000 live births. It is more common in boys and black children compared to white. The white and Hispanic incidence is similar. This may be reflective of the higher preterm birth rate amongst urban black women. Over 77% of children with Cerebral Palsy have the spastic type. And, over 58% can walk independently. Commonly associated conditions are epilepsy and Autistic Spectrum Disorder (ASD).
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In one analysis, over 58% can walk independently while 11.3 % used a hand-held device to walk and 30.6% had no walking ability or very limited ability. Black children with cerebral palsy were 1.7 times more likely to have limited or no walking ability compared to white children. Resource allocation for early interventions might explain this discrepancy. The ability to walk, crawl and play were reduced in 41% of children and 31% required walkers or wheelchairs.
Co-Occurring Developmental Disabilities
The prevalence of ASD among children is about 1%, but the prevalence was even higher among children with cerebral palsy. The type of Cerebral Palsy associated with autism was the non-spastic, hypotonic type of CP. Co-existing epilepsy was highest in children with CP who had limited or no walking ability. With regard to other disabilities, 60% of CP sufferers had another disability. According to one study, intellectual problems were found in 40%, and 15% had a visual impairment. 25 % of children had both an intellectual problem and a seizure disorder.
Incidence of Risk Factors associated with CP
Low birth weight and prematurity
This disability occurred in 6.2 per 1000 live births of babies in the birth weight range of 3.5-5.5 pounds, and this increased to 59.5 per 1000 live births weighing less than 3.5 pounds. Babies over 5.5 pounds had only a 1.1 chance in 1000 of developing CP. The biggest risk factor for the low birth rate is a premature birth.
Data from Europe and Australia, between 28 to 31 weeks gestation, 35-79 CP babies out 1000 were born, while Sweden had 43 out 1000 births for the same gestational ages. From 32 to 36 weeks gestation, six out 1000 had CP. Multiple gestations result in higher rates primarily due to lower birth rate and prematurity. Likewise, in-vitro fertilization babies were 1.6 times more likely to have CP, again due to multiple gestation and prematurity.
Disruption of Blood and Oxygen Supply to the Developing Brain
Hypoxia/Asphyxia during the birth process accounts for less than 10% of CP cases. Ischemic stroke leads to lack of oxygen to the developing brain and can cause brain damage before or after birth. It can be from bleeding into the brain or from a blood clot blocking a vessel in the brain
Infection Among Pregnant Mothers
Chorioamnionitis, which is an infection of the placental membranes or sepsis which is a blood infection in the mother during labor is associated with an increased risk of CP in children born full-term or pre-term. The rate of spastic CP is 12% in full-term infants of mothers with chorioamnionitis and 28% of those born prematurely. A urinary tract infection in the mother is associated with an increased risk of cerebral palsy if the child is born prematurely or is of low birth weight.
Other Factors
Birth defects or malformations of the fetal brain are more commonly found in children with CP while traumatic brain injury combined with meningitis in the early childhood years are the causes of CP in 10-15% of cases.