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The incidence and implications of cerebral palsy following potentially avoidable obstetric complications: a preliminary burden of disease study
Author(s) -
Leigh S,
Granby P,
Turner M,
Wieteska S,
Haycox A,
Collins B
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12897
Subject(s) - cerebral palsy , medicine , population , gross motor function classification system , pediatrics , incidence (geometry) , asphyxia , cohort , cumulative incidence , cohort study , physical therapy , physics , environmental health , optics
Objective To determine the extent of cerebral palsy attributable to adverse obstetric events, and estimate the lifetime mortality and morbidity expectations of these individuals relative to age‐matched members of the UK general population. Design Simulation model. Setting UK . Population All projected live births during 2014. Methods Using published data regarding the incidence and aetiology of cerebral palsy, we simulated the outcomes of a hypothetical cohort of UK live births. Survival and quality of life (QoL) for those with cerebral palsy were compared with age‐matched individuals representative of the UK general population, in order to estimate the number of quality‐adjusted life years ( QALY s) lost following asphyxia‐related cerebral palsy. Main outcome measures Incidence of asphyxia‐related cerebral palsy, QALYS , QoL, and survival. Results A total of 207 (95% CI 169–245) cases of asphyxia‐related cerebral palsy were projected amongst UK children born during the year 2014, with approximately 15.2 QALY s lost per case. If these results held true in a real birth cohort, 3142 (95% CI 2321–3963) QALY s would be lost as a consequence of asphyxia‐related cerebral palsy, a loss valued by the UK National Health Service at £62.9 m (95% CI £46.4–79.3 m). Conclusions Cerebral palsy following intrapartum asphyxiation leads to significant reductions in QoL and survival; however, this may often be prevented. For those with GMFCS 1 and GMFCS 2 cerebral palsy (Gross Motor Function Classification System), lifetime QALY s accrued largely resemble those experienced by the UK general population, whereas for GMFCS 3 and GMFCS 4 QALY s are reduced considerably, and are negative in the case of GMFCS 5.