Epidemiological characteristics of cerebral palsy in twelve province in China

Objective To investigate the epidemiological characteristics of cerebral palsy (CP) in children aged 1-6 years in China, including the incidence, prevalence, type of CP, etiology, prevention and rehabilitation status. Methods The survey was carried out by standard questionnaires, multi-center collaboration, stratified-cluster random sampling method.The surveyed adopted the following principles: streets in the city and villages in the rural areas, and the number of the urban and rural children was the same, and the proportion of children in each age group was balanced.The investigation areas included provinces and autonomous regions, including Heilongjiang, Beijing, Henan, Shandong, Shanxi, Shaanxi, Anhui, Hunan, Guangxi, Guangdong, Chongqing and Qinghai, and 323 858 children were investigated. Results The incidence of CP was 2.48‰(155/62 591 cases), and the prevalence was 2.46‰(797/323 858 cases) (1-6 years old). The prevalence varied in different regions, in which the highest prevalence was 5.40‰(54/9 998 cases) in Qinghai province, and the lowest prevalence was 1.04‰(47/45 133 cases) in Shandong province.The prevalence of the males (2.64‰, 461/174 391 cases) was higher than that of the females (2.25‰, 336/149 467 cases), and the difference was statistically significant (P<0.05). The types of CP were spastic type (58.85%, 469/797 cases), mixed type (13.17%, 105/797 cases), dyskinetic (9.79%, 78/797 cases), hypotonic (8.28%, 66/797 cases), ataxia (6.25%, 52/797 cases) and rigid (3.39%, 27/797 cases) respectively in 797 CP children.The first three risk factors for CP were long-term exposure to harmful physical factors during pregnancy, whether there were birth defects among the three generations of relatives of the children, such as children′s peers, parents or grandparents, whether there were birth defects among the children′s peers, parents or grandparents, and neonatal jaundice or persistent jaundice.Among 797 CP children, 79.67% of the children with CP were timely detected and treated in the local hospitals, while the other 19.93% of them were not timely treated.The places which could give them timely detection and early diagnosis and treatment were general hospitals (42.97%), Maternity and Infant Hospitals (27.03%) and Children′s Hospitals (20.31%). The main rehabilitation methods for 797 children with CP were 34.58% in the hospitals or rehabilitation centers, 31.61% in the communities (including at home), 33.80% mainly in the medical institution, and in the communities they could also receive partially rehabilitation services. Conclusions The prevalence of CP in China is coincident with international levels.The prevalence rate of CP in males is higher than that in females.The types of CP distribution are accorded with international distribution characteristics.There were still some children with CP who could not receive timely detection and treatment.Rehabilitation at the medical institutions is the chief way and proper rehabilitation guidance should be carried out in the communities. Key words: Cerebral palsy; Epidemiology; Prevalence; Prevention; Treatment; Rehabilitation