Cerebral palsy (CP) is a chronic non-progressive disability of the CNS characterized by aberrant control of movement and posture appearing early in life. Cost estimates to treat children with CP exceed 5 billion dollars annually and the prevalence of CP has actually increased over the past several decades. Approximately 10% of cases of CP can be directly connected with complications surrounding birth or birth trauma. Most studies to date on the etiology of CP have limited numbers of cases or were performed in the past before modern obstetrical care had been introduced. The California Department of Health Services (DHS) maintains many computer databases including that of all maternal and newborn hospital discharge records, vital statistics birth certificates, and the CP MediCal billing database. The CP MediCal database contains all children with CP and MediCal insurance and contains diagnostic and treatment codes related to CP. In this project we will link the DHS pregnancy related databases with that of the CP MediCal database to identify the delivery records of all children with CP who delivered in California. This joined database will provide the antepartum, intrapartum, and postpartum records of the mothers of, and children with, CP. This large database will allow us to examine any antenatal admissions, pregnancy and delivery complications, newborn complications and infant hospital readmissions during the first year of life. The expected large number of children identified (5,000) will provide the largest population based study to date and should help us identify high risk groups for possible early intervention or reallocation of resources. We will compare those children with CP to a control group matched for multiple demographic, antenatal, and delivery outcomes to identify the risk factors for the development of CP. The large population of patients will alllow us to separate out the term from preterm delivered infants and identify separate risk factors based on gestational age at delivery. This project will allow us to link the databases and start initial data analysis. ? ? ?
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