FRIDAY, Jan. 5, 2007 (HealthDay News) -- British researchers are reporting a decline in cerebral palsy among the most vulnerable newborns, and American pediatricians say a similar trend is probably happening in the United States.
Data on 1,575 babies of very low birth weight or those born of multiple pregnancies at 16 European centers showed a decline in the prevalence of cerebral palsy from 60.6 per 1,000 in 1980 to 39.5 in 1996.
The decline in cerebral palsy, a group of disorders that affect body movement and muscle coordination, has occurred while such babies have a better chance of survival, the report said. The improvements are especially marked in newborns weighing less than one kilogram (2.2 pounds). The researchers attributed the advances to general improvement in neonatal care.
The study findings, by researchers at the University of Liverpool, are published in the Jan. 6 issue of The Lancet.
The numbers show that "improvement in neonatal care has not resulted in increased survival at the cost of substantial morbidity," the report said.
A paper reporting a similar decline in the incidence of cerebral palsy in high-risk infants at one U.S. hospital, Rainbow Babies and Children's Hospital in Cleveland, is about to be published, said Dr. Maureen Hack, a professor of pediatrics at Case Western Reserve University. Hack is co-author of that paper and an editorial accompanying The Lancet report. She's also in charge of high-risk infants at the hospital.
But a lack of data on U.S. births makes it impossible to say definitely that the improvement is nationwide, she said.
"As far as I can tell, no one else has reported this," Hack said.
But her co-author, Dr. Deanne Wilson Costello, an associate professor of pediatrics at Case Western Reserve University, said, "Anecdotally, pediatricians seem to be reporting similar trends, and I suspect we will see similar reports pop up around the United States."
One major factor in the improvements in survival and reduced incidence of cerebral palsy is two very different uses of steroids, Hack and Costello said.
"In the 1990s, people started using antenatal steroids," given to women before delivery, Hack said. Antenatal steroids decrease the incidence of brain hemorrhage in the babies, she noted.
But in the 1990s, pediatricians were giving steroids to many high-risk babies after birth. Those steroids helped the infants get off respirators faster, but they were also found to have a profoundly dangerous side effect, impairing brain development, Costello said.
"In about 2000, the American Academy of Pediatrics came out with a statement saying they didn't recommend that use of steroids," Costello said. "Some centers are still using them, but we use them infrequently and for a very short amount of time."
It will take time for U.S. statistics on cerebral palsy to emerge because "after children are born, it takes two years for an outcome that is reliable," Costello said.
"I suspect we will see reports that the incidence is lower, but they haven't come out yet," she said.
More information
The U.S. National Institute of Neurological Disorders and Stroke can tell you more about cerebral palsy.
