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In the 30 years between 1974 and 2003, 2318 extremely premature babies were born in northern Alberta, Canada. Of the 858 who survived to 2 years of age 14.2% (122) had cerebral palsy. But the prevalence has ebbed and flowed, peaking at 131 per 1000 live births in the mid-1990s and falling steadily since to an all time low of 19 per 1000 live births by 2003, according to analysis of time trends.trends.
All the children in this study were born at between 20 and 27 weeks' gestation, weighing less than 1249 g. In 1974 babies born this premature in northern Alberta had a 12% chance of reaching their 2nd birthday. By 2003 survival had improved to 51%. The prevalence of cerebral palsy fell in the past decade for children born between 20 and 25 weeks' gestation and for children born slightly later (26 or 27 weeks).
The positive trend seems unrelated to an increase in the number of premature babies born by caesarean section, say the authors. Size for gestational age and multiple births were also unrelated to the risk of cerebral palsy. The real cause of the decrease remains unknown, but the authors suspect it may have something to do with improved care after a series of important clinical trials.