Early childhood development: the global challenge.

8 www.thelancet.com Vol 369 January 6, 2007 analysis of the incidence of cerebral palsy in survivors, enabling assessment of special health-care needs and the potential burden to the health-care system and to families. Despite the encouraging decrease in the prevalence of cerebral palsy reported by the SCPE group, which is consistent with fi ndings from our institution for infants of less than 1000 g birthweight born between 2000 and 2002, there is no cause for complacency. Cerebral palsy is associated with major disabilities: in the SCPE study, 35·2% of children with bilateral spastic cerebral palsy were unable to walk and 23·5% of children had severe mental retardation (ie, intelligence quotient <50). Furthermore, both the SCPE study and data from the USA have recorded an increase in the number of livebirths of very low birthweight, which might lead to an increase in the number of children with cerebral palsy. Therefore every eff ort needs to be invested in the prevention of preterm birth and its associated brain injury. *Maureen Hack, Deanne Wilson Costello Rainbow Babies and Children’s Hospital, Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA [email protected]