Severe Congenital Heart Defects and Cerebral Palsy

Abstract

Objective: To report the prevalence of cerebral palsy (CP) in children with severe congenital heart defects (CHD) and the outcome/severity of the CP.

Methods: Population-based, data-linkage study between cerebral palsy and congenital anomaly registers in Europe and Australia. The EUROCAT definition of severe CHD (sCHD) was used. Linked data from four regions in Europe and two in Australia were included. All children born in the regions from 1991 through 2009 diagnosed with CP and/or sCHD were included. Linkage was completed locally. De-identified linked data were pooled for analysis.

Results: The study sample included 4989 children with CP and 3684 children with sCHD. The total number of livebirths in the population was 1,734,612. The prevalence of CP was 2.9 per 1000 births (95% CI 2.8-3.0) and the prevalence of sCHD was 2.1 per 1000 births (95% CI 2.1-2.2). Of the children with sCHD, 1.5% (n=57) had a diagnosis of CP of which 35 (61%) children had pre/perinatally acquired CP (resulting from a brain injury up to 28 days of life) and 22 (39%) children had a post-neonatal cause (a brain injury between 28 days and 2 years). Children with CP and sCHD more often had unilateral spastic cerebral palsy and more intellectual impairments than children with CP without congenital anomalies.

Conclusions: In high-income countries, the proportion of children with CP is much higher in children with sCHD than in the background population. The severity of children with CP and sCHD is milder compared with children with CP without congenital anomalies.