Introduction During the last decade survival rates of preterm children continuously improve. It is under debate whether this influences the incidence of cerebral palsy (CP).
Objective To determine changes in incidence of CP and motor disorders in preterm children since 2004, and to identify associated factors.
Methods We included all infants born < 32 weeks, admitted to our tertiary NICU, born in 2004–2005 (period-I) and in 2008–2009 (period-II). We excluded children transferred from other tertiary NICUs, with major malformations, and neuromuscular disorders. We compared the incidence of CP and other motor disorders at the age of 2 years. To identify potential risk factors, we used the Nursery Neurobiologic Risk Score (NBRS), including pH, ventilation, infection, convulsions, intraventricular hemorrhage, periventricular leukomalacia, and hypoglycemia.
Results 558 children were included; 269 period-I and 289 period-II. The incidence in CP was not significantly different: 5.6% vs 6.6%, respectively. The number of children with other motor disorders was significantly higher in period-I than in period-II: 15 vs 5 (5.6% vs 1.7%, p< 0.05). NBRS-scores were median 2.5 vs 2.0 (p=0.12). In period-I, pH and infection contributed more to a higher NBRS, whereas mild periventricular leukomalacia did in period-II (all p< 0.05). Total and subscores of the NBRS were strongly related to CP (p< 0.01), apart from hypoglycemia in both periods, and ventilation and suspected infections in period-I.
Conclusions Since 2004, the incidence of CP in preterm children did not change, but rates of other motor disorders decreased, without considerable changes in associated risk factors.