低出生体重与脑性瘫痪

Low Birth Weight and Cerebral Palsy

目的 确定不同出生体重脑性瘫痪患病率。 方法 １９９７ 年５ 月至６ 月在江苏南部七个市进行了０～６ 岁小儿脑性瘫痪现况调查。 结果 随着出生体重的增加，脑性瘫痪患病率呈现出下降、平台和上升三种变化。出生体重在３ ５００ ～３ ９９９ ｇ 组的脑性瘫痪患病率最低。低出生体重儿（ ＜２ ５００ ｇ）占全部儿童的２－０％ ，而在脑性瘫痪患儿中低出生体重儿却占２４％ 。低出生体重儿脑性瘫痪患病率为１９－４‰（９５％ 可信区间：１６－３‰～２２ ．５ ‰），而正常出生体重儿（ ≥２ ５００ ｇ） 为１－２‰（９５ ％ 可信区间：１－１ ‰～１ ．３‰）；低出生体重儿脑性瘫痪患病率是正常出生体重儿的１６ 倍（ＲＲ＝１６－１，９５％ 可信区间：１３－４ ～１９－４）。 结论 低出生体重儿脑性瘫痪患病率明显高于正常出生体重儿；调查地区出生体重不足２ ０００ ｇ 的儿童的存活质量有待进一步提高；随着低出生体重儿存活率的上升，脑瘫患病率可能会呈上升趋势。

Objective To determine the birth weight specific prevalence of cerebral palsy(CP). Methods A prevalence study of cerebral palsy was carried out among 388 192 children aged under 7 years old in seven cities of Jiangsu Province during period of May June 1997. Results The study showed that the prevalence of CP was of three change patterns(decreasing,stable and increasing patterns) as birth weight increased.Children with birth weight of 3 500 to 3 999 g were at the lowest risk.Children with birth weight <2 500 g,who were 2.0% of total children,contributed 24% to the CP in this population.The prevalence of CP for low birth weight(<2 500 g)was 19.4‰(95% confidence interval:16.3‰～ 22.5‰ ),while that for normal birth weight was 1.2‰(95% confidence interval:1.1‰～1.3‰).The former was 16 times higher than the latter (RR=16.1,95% confidence interval:13.4～19.4). Conclusions The prevalence of cerebral palsy for children with low birth weight was much higher than that for children with normal birth weight.The survival quality of children with birth weight <2 000 g needed to be further improved.It is estimated that the prevalence of cerebral palsy may be of a tendency to increase as survival rate of newborns increases with low birth weight.