UKCP Collaboration: regional variations in the relationship between cerebral palsy and socio-economic deprivation
This study aimed to investigate whether the prevalence of cerebral palsy varies according to socio-economic status, as indicated by a small area deprivation measure. Data from the five cerebral palsy registers in the UKCP collaboration (including the 4Child Register) were linked to small area deprivation codes to enable rates of disease by deprivation to be investigated. The prevalence of postneonatally acquired cerebral palsy was 0.14 per 1,000 livebirths overall. The mean deprivation gradient, expressed as the relative risk in the most deprived quintile group versus the least was 1.86 (95%CI 1.19 to 2.88). The prevalence of antenatally or perinatally acquired cerebral palsy was 2.2. per 1,000 livebirths and the gradient was 1.16 (95%CI 1.00 to 1.35). Evidence of a socio-economic gradient was strongest for spastic bilaternal cases with a relative risk of 1.32 (95%CI 1.09 to 1.59) and cases with severe intellectual impairment with a relative risk of 1.59 (95%CI 1.06 to 2.39). There was evidence of differences in gradient between regions. and there was non-significant evidence of a reduction in socio-economic gradient over time. The reduction of the higher rates of postneonatally acquired cerebral palsy in the more socio-economically deprived areas is a clear goal for prevention. While we found evidence of a socio-economic gradient for cerebral palsy of antenatal or perinatal origin, the picture was not consistent across regions. The steeper gradients in some regions for normal birthweight cases and cases with severe intellectual impairement requires further investigation. A paper reporting these findings has been published in Paediatric and Perinatal Epidemiology.