- 作者：Yuki Kodama ; yuki_kodama@med.miyazaki-u.ac.jp" class="auth_mail" title="E-mail the corresponding author ; Hiroshi Sameshima ; Tsuyomu Ikenoue
- 关键词：Cerebral palsy ; Perinatal mortality ; Population-based study ; Periventricular leukomalacia ; Asphyxia
- 刊名：Brain and Development
- 出版年：2016
- 出版时间：April 2016
- 年：2016
- 卷：38
- 期：4
- 页码：386-391
- 全文大小：680 K
Methods
This unselected, population-based study was conducted in Miyazaki prefecture, Japan (10,000 deliveries annually), where 102,999 deliveries were registered between 2001 and 2010. Of these, 312 were stillbirths (⩾22 weeks of gestation), 126 were neonatal deaths (<28 days of birth), and 214 infants were determined to be at risk of CP at peer-review conferences. Survival and neurological damage were compared for two 5-year periods, 2001–2005 and 2006–2010, and infants were classified according to gestational ages.
Results
Stillbirths and neonatal deaths decreased significantly during both periods. Likewise, the number of registered high-risk cases of CP decreased by 30.2%, from 126 to 88 cases. After excluding congenital anomalies, the corrected CP prevalence was 1.5 per 1000 (78/51,889) and 1.3 per 1000 (67/51,110), for the two periods, which was not a significant difference. The number of extremely preterm infants (22–25 weeks) did not change over the 10-year period, whereas that of moderately preterm infants (26–36 weeks) increased, and that of term infants significantly decreased (p < 0.01). In term infants, asphyxia decreased from 18 to 7 cases (p < 0.05).
Conclusions
Perinatal deaths and CP decreased in prevalence during both 5-year periods, and the CP prevalence was 2.1 per 1000 births. Furthermore, fewer term infants were at high risk for CP mainly because of the reduced prevalence of asphyxia.