Prevalence of Cerebral Palsy Higher in Lower-Income, Rural Areas, Taiwan Study Finds

Prevalence of Cerebral Palsy Higher in Lower-Income, Rural Areas, Taiwan Study Finds

Low family income and living in rural areas are associated with higher prevalence of cerebral palsy, a study from Taiwan shows.

The research, “Association between socioeconomic status and cerebral palsy,” was published in the journal PLOS One.

Disability associated with cerebral palsy (CP) imposes significant demands on health, education, and social services, the study authors contend. That is why it is of vital importance to obtain updated data on the risk factors associated with CP in order to allocate appropriate health resources.

Research showed that the prevalence of CP is higher in developing countries such as Uganda and Egypt, than it is in Europe, Australia or the U.S. Moreover, the disease is less prevalent in Asian than in Caucasian children in the U.S., but researchers are still unclear whether this difference can be attributed to ethnic disparities. Data also showed that CP is more frequent in boys and in patients with low socioeconomic status (SES).

The research team analyzed the annual prevalence of CP among children in Taiwan age 7 or younger, as well as the association between CP prevalence and SES. The investigators used data from the Taiwan Health Insurance Research Database, recorded from 2002 to 2008.

The study focused on both total and severe CP. Total CP definition was based on medical claim records, but severe CP required a definite CP diagnosis and moderate-to-severe physical or mental disability.

Results showed that the annual prevalence of total and severe CP in Taiwan ranged from 1.9 to 2.8, and from 1.1 to 1.4 per 1,000 children, respectively. This is similar to data from Western countries, which contradicts previous reports.

Unlike total CP, which was higher in the period 2003-2008 than in 2002, severe CP remained stable throughout the seven years of analysis.

Matching previous data, boys were found to be 30 percent more likely to have CP than girls.

Regarding the association of CP and SES, children from families with low family income had a fivefold higher prevalence of both total and severe disease than middle- or high-income families. This result is in accordance with data from U.S. and U.K. studies.

“The trend of higher CP prevalence in low-income families warrants further investigation to reduce the CP rate in this population,” the researchers wrote.

Among the factors potentially explaining the link between SES and CP, maternal illness, inadequate prenatal care, poor nutrition, alcoholism, and smoking have been suggested.

Furthermore, CP was more frequent in patients living in rural regions, compared to those in urban or suburban areas. Because residents of rural areas are less likely to use medical services, it is important to expand access to these services to ensure optimal development and care of these children, the researchers emphasized.

The mortality rate of severe CP ranged from 12.2−22.7 per 1,000 children. These values are higher than those of developed countries. Further studies are warranted to analyze what drives this high mortality, they stated.

“Developing a nationwide CP register system to thoroughly understand the prevalence and causes of CP and provide improved healthcare to children with CP is imperative,” researchers concluded.