Published online February 29, 2008
PEDIATRICS Vol. 121 No. 3 March 2008, pp. 547-554 (doi:10.1542/peds.2007-1270)
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ARTICLE

Prevalence of Cerebral Palsy in 8-Year-Old Children in Three Areas of the United States in 2002: A Multisite Collaboration

Marshalyn Yeargin-Allsopp, MDa, Kim Van Naarden Braun, PhDa, Nancy S. Doernberg, BAa, Ruth E. Benedict, DrPH, OTRb,d, Russell S. Kirby, PhDc and Maureen S. Durkin, PhD, DrPHd,e

a National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
b Department of Kinesiology
d Waisman Center
e Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
c Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama

OBJECTIVE. The goal was to estimate the prevalence of cerebral palsy and cerebral palsy subtypes among children in 3 areas of the United States by using a population-based surveillance system.

METHODS. Using methods developed by the Centers for Disease Control and Prevention Metropolitan Atlanta Developmental Disabilities Surveillance Program, investigators from the Autism and Developmental Disabilities Monitoring Network conducted surveillance of cerebral palsy among 8-year-old children living in northern Alabama, metropolitan Atlanta, and southeastern Wisconsin in 2002 (N = 114897). Cross-sectional data were collected through retrospective record review from multiple sources. Cases were linked to birth certificate and census files to obtain additional information. Period prevalence estimates were calculated per 1000 children 8 years of age.

RESULTS. The average prevalence of cerebral palsy across the 3 sites was 3.6 cases per 1000, with notably similar site-specific prevalence estimates (3.3 cases per 1000 in Wisconsin, 3.7 cases per 1000 in Alabama, and 3.8 cases per 1000 in Georgia). At all sites, prevalence was higher in boys than girls (overall boy/girl ratio: 1.4:1). Also, at all sites, the prevalence of cerebral palsy was highest in black non-Hispanic children and lowest in Hispanic children. At all sites, the prevalence among children living in low- and middle-income neighborhoods was higher than that among children living in high-income neighborhoods. Spastic cerebral palsy was the most common subtype (77% of all cases), with bilateral spastic cerebral palsy dominating the spastic group (70%).

CONCLUSION. These findings contribute new knowledge to the epidemiology of cerebral palsy in the United States. The similarities in prevalence rates and patterns of cerebral palsy reported for 8-year-old children at 3 geographically distinct sites provide evidence of the reliability of the surveillance methods used by the Autism and Developmental Disabilities Monitoring Network.

Key Words: prevalence • cerebral palsy • developmental disabilities • population-based surveillance

Abbreviations: ADDM—Autism and Developmental Disabilities Monitoring • CP—cerebral palsy • SES—socioeconomic status • CI—confidence interval

Accepted Aug 15, 2007.


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