LIFE EXPECTANCY IN CHILDREN WITH CEREBRAL-PALSY

Objective-To determine life expectancy of children with cerebral palsy . Design-Cohort analysis, by means of register compiled from multiple sources of ascertainment, of all children with cerebral palsy born dur ing 1966-84 to mothers resident in Mersey region. Status of children w as determined by flagging through NHS central register. Subjects-1258 subjects with idiopathic cerebral palsy, of whom 1251 were traced and included in analysis. Main outcome measures-Effect of functional abili ty (ambulation, manual dexterity, and mental ability), sex, birth weig ht, and gestational age on survival. Results-20 year survival for whol e cohort was 89.3% for females and 86.9% for males. For subjects with no severe functional disabilities 20 year survival was 99% (95% confid ence interval 98% to 100%), while subjects severely disabled in all th ree functional groups had 20 year survival of 50% (42% to 58%). Subjec ts with birth weight less than or equal to 2500 g had 20 year survival of 92% (89% to 95%), while those with birth weight >2500 g had surviv al of 87% (84% to 89%). Subjects with gestational age of >37 weeks had 20 year survival of 93% (91% to 96%), white those with gestational ag e greater than or equal to 37 weeks had survival of 85% (83% to 88%). Birth weight and gestational age were less predictive of survival than functional disability. Best statistical model used gestational age an d number of severe functional disabilities as predictors. Conclusions- Life expectancy of this cohort of children with cerebral palsy was gre ater than has been suggested in some previous studies. This has import ant implications for social, educational, and health services.