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We aimed to study the rates and trends over time of children with cerebral palsy (CP) of post-neonatal origin (arising more than 28 days after birth, and before the age of 25 months), to examine their aetiology and associated significant risk factors, and to compare them with other CP cases. Children with post-neonatal CP born 1976-90 were identified from a European database and seven registers were included (Surveillance of Cerebral Palsy in Europe collaboration). Using a previously published classification it was possible to allocate an aetiology to 99% of cases. The prevalence rate of post-neonatal CP was 1.26 per 10 000 live births and a significant decrease was observed over the period 1976-90 (P = 0.011). Infection accounted for 50%, vascular episodes for 20% and head injury for 18% of the cases. Although there has been little change in the profile of underlying causes in this period, within the infection group, a significant downward trend was observed for Reye's syndrome (P < 0.001) and non-central nervous system (non-CNS) infection (P = 0.004), but not for meningitis/encephalitis. There was evidence of some increased risk of post-neonatal CP among children with low birthweight (<2500 g) (P < 0.001). Overall children with CP of post-neonatal origin showed a more severe functional pattern than non-post-neonatal CP children. In order to ascertain the impact of public health and other preventive measures aimed at reducing the frequency of brain injury in the first 2 years after birth, it is necessary to continue to monitor the frequency and characteristics of children with post-neonatal CP into the 1990s.

Background: Public health indicators (PHIs) play an increasingly important role in health policy decision-making. Although cerebral palsy (CP) is the commonest physical disability in children, its impact at population level has not been systematically measured so far. Objectives:We aimed to propose six PHIs for CP designed to annually document the extent of CP and effectiveness of perinatal organisation, the burden of this condition, access to health services and preventive health strategies in the post-neonatal period and to report on the latest updated estimations using population-based data routinely collected by European CP registries. Methods:The study included children with CP born between 2002 and 2011.Harmonised data (number of cases, functional profile, imaging) were extracted from the Surveillance of Cerebral Palsy in Europe (SCPE) database. Eligibility criteria for analyses were applied separately for each indicator by selecting registries, birth years and CP cases. Current estimates were based on the last 3 birth years, while trends were reported over a 10-year period. All analyses were descriptive. Sensitivity analyses were carried out to examine the stability of the results using various thresholds of percentages of missing values.Results: Analyses were performed on a total of 8621 children with CP from 12 to 17 SCPE registries. A decreasing prevalence of pre/perinatal CP overall, as well as in preterm and full-term-born children, was observed. The burden of the condition was strongly dependent on CP subtype and the presence of associated impairments.Access to brain imaging ranged from 80% to 100% depending on registries. The overall prevalence of post-neonatally acquired CP was approximately 0.8 per 10,000 live births over the study period.

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