Abstract
Background: Early diagnosis of cerebral palsy (CP) enables timely intervention and improved outcomes. International guidelines recommend standardized tools such as magnetic resonance imaging (MRI), the Hammersmith Infant Neurological Examination (HINE), and the Prechtl General Movements Assessment (GMs). In Belgium, a structured and reimbursed neonatal follow-up program for preterm infants (prematurity convention) was introduced in 2012. This study evaluated how the diagnostic process of CP has evolved in this context.
Methods: We conducted a retrospective cohort study including children with CP admitted to the Neonatal Intensive Care Unit of University Hospitals Leuven. Two birth cohorts were compared: pre-implementation (2006-2010) and post-implementation (2016-2020). Clinical and neurodevelopmental data were extracted from medical records. Primary outcomes were age at diagnosis and use of standardized tools. Secondary outcomes included timing of parental communication, referral to specialized care, and initiation of early interventions.
Results: Seventy-eight children were included (38 in 2006-2010; 40 in 2016-2020). Median age at diagnosis did not differ significantly between cohorts (12.0 vs. 10.5 months; p=0.564). Children with higher Gross Motor Function Classification System (GMFCS) levels were diagnosed earlier (p=0.003). The more recent cohort showed earlier communication of motor concerns, earlier referral, and earlier initiation of interventions such as constraint-induced movement therapy and home guidance.
Conclusions: Despite the introduction of structured follow-up, age at diagnosis did not decrease. However, diagnostic age was comparable to international programs with full guideline implementation. Improvements in communication, referral, and intervention timing were observed over time. Further integration of standardized tools may enhance early detection and outcomes.