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To the Editor: In their study of clinical and magnetic resonance imaging (MRI) correlates of cerebral palsy (CP), Dr Bax and colleagues¹ note that they were unable to achieve the target of identifying 100 children with CP. The authors provide 4 possible reasons for the failure to reach the anticipated numbers, but state that "the most likely explanation is that there was some underidentification of mild cases in most centers because of the organization of services and methods of identification. . . . There is no real evidence from the study that the lower numbers reflect a decrease in the 2-per-1000 live birth rate for CP." I would like to know the basis for their assertion that the lower numbers are because of their methods, not an actual decrease in the rate of CP.

In addition, the authors state that "26% of mothers had emergency cesarean deliveries, indicating that the obstetrician was well aware . . . [Full Text of this Article]

Russel D. Jelsema, MD
rdj_1960@hotmail.com
Michigan State University
Grand Rapids

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