Research article

Cerebral palsy in a total population of 4–11 year olds in southern Sweden. Prevalence and distribution according to different CP classification systems

Lena Westbom^1,4 , Gunnar Hagglund^2,4 and Eva Nordmark^3,4

¹Division of Paediatrics, Department of Clinical Sciences (Lund), Lund University, Lund, Sweden

²Department of Orthopaedics, Department of Clinical Sciences (Lund), Lund University, Lund, Sweden

³Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden

⁴Children's Hospital, University Hospital, SE 221 85 Lund, Sweden

author email corresponding author email

BMC Pediatrics 2007, 7:41doi:10.1186/1471-2431-7-41

Published:	5 December 2007

Abstract

Background

The aim of this study was to investigate the prevalence of cerebral palsy (CP) as well as to characterize the CP population, its participation in a secondary prevention programme (CPUP) and to validate the CPUP database.

Methods

The study population was born 1990–1997 and resident in Skåne/Blekinge on Jan 1^st 2002. Multiple sources were used. Irrespective of earlier diagnoses, neuropaediatrician and other professional medical records were evaluated for all children at the child habilitation units. The CPUP database and diagnosis registers at hospital departments were searched for children with CP or psychomotor retardation, whose records were then evaluated. To enhance early prevention, CP/probable CP was searched for also in children below four years of age born 1998–2001.

Results

The prevalence of CP was 2.4/1,000 (95% CI 2.1–2.6) in children 4–11 years of age born in Sweden, excluding post-neonatally acquired CP. Children born abroad had a higher prevalence of CP with more severe functional limitations. In the total population, the prevalence of CP was 2.7/1,000 (95% CI 2.4–3.0) and 48% were GMFCS-level I (the mildest limitation of gross motor function).

One third of the children with CP, who were born or had moved into the area after a previous study in 1998, were not in the CPUP database. The subtype classification in the CPUP database was adjusted in the case of every fifth child aged 4–7 years not previously reviewed.

Conclusion

The prevalence of CP and the subtype distribution did not differ from that reported in other studies, although the proportion of mild CP tended to be higher.

The availability of a second opinion about the classification of CP/CP subtypes is necessary in order to keep a CP register valid, as well as an active search for undiagnosed CP among children with other impairments.