Premature babies have a better chance of survival without severe neurological impairment than in they did in the early 80s, according to an Article in The Lancet. The study shows that the prevalence of cerebral palsy in children of very low birthweight has fallen since 1980.

Cerebral palsy is a permanent, but changing disorder of movement, posture, and motor function. It is the commonest disability of children in western Europe, with a birth prevalence of about two cases per 1000 live births. Infants of very low birth weight (VLBW)--those born weighing less than 1500 g--and multiple pregnancies are between 20 and 80 times more likely to have cerebral palsy than infants of normal birthweight. During the 1980s data suggested that the prevalence of cerebral palsy among VLBW infants increased, but recent reports suggest that the prevalence within this group of infants has begun to fall.

To investigate, Mary Jane Platt (Division of Public Health, Liverpool University, Liverpool, UK) and colleagues pooled data from a group of 16 European centres, to analyse the distribution and frequency of cerebral palsy by sex and neurological subtype in VLBW infants, in the period 1980-96. 1575 VLBW infants were born with cerebral palsy, of which 414 (26%) were of birthweight less than 1000g, and 317 (20%) were from multiple pregnancies. The researchers found a significant fall in the prevalence of cerebral palsy in VLBW infants over the study period from 60.6 per 1000 livebirths in 1980 to 39.5 in 1996. The authors suggest that the reduction in the prevalence of cerebral palsy is a result of general improvements in neonatal care.

Dr Platt states: "In conclusion, this paper presents evidence that infants of birthweight less than 1500 g, and in particular those of birthweight less than 1000 g now have a better chance of survival than previously, and more importantly, a better chance of survival without severe neurological impairment, which demonstrates that improvement in neonatal care has not resulted in increased survival at the cost of substantial morbidity."

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Contact: Dr Mary Jane Platt,
Division of Public Health,
Whelan Building,
The University of Liverpool,
Liverpool
L69 3GB, UK.

Contact: Joe Santangelo
Lancet