Weird skin changes during pregnancy, tennis and long life, bowel cancer and cerebral palsy

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Health Report 28 min 3 speakers 8 chapters transcribed 3 days ago

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What is the health report’s opening focus and why do tennis players live longer than gym‑goers?

Tegan Taylor 0:01

This is an ABC podcast.

Dr. Norman Swan 0:07

Hello and welcome to this week's health report with me, Norman Swan. Today, why do tennis players live years longer than people who go to the gym? How to cut the death rate from bowel cancer by 80% and a question to ask your GP about the specialist they're referring you to for your colonoscopy. the things that happen to women's skin when they're pregnant, and amazingly good news about babies and children with cerebral palsy. According to the Australian Cerebral Palsy Register, the rates are falling dramatically. Professor Nadia Badawi is Chair of Cerebral Palsy at the Children's Hospital Westmead, and I spoke to her just before we went to air.

How is cerebral palsy defined and what does the Australian Cerebral Palsy Register reveal about its incidence?

Dr. Norman Swan 0:46

So Nadia, welcome back to the Health Reports.

Nadia Badawi 0:47

Thank you.

Dr. Norman Swan 0:48

So tell me what exactly you're announcing tonight,

Nadia Badawi 0:50

because this

Dr. Norman Swan 0:50

is a register. of babies born with

Nadia Badawi 0:54

cerebral palsy or children diagnosed with it. That's right. Cerebral palsy is the most common physical disability of childhood and it affects movement. It's lifelong and it is also sometimes accompanied by intellectual disability, epilepsy. It's a complex condition and we're very fortunate in Australia to have the Australian Cerebral Palsy Register.

Dr. Norman Swan 1:17

We should just explain what cerebral palsy is. It's brain damage

Nadia Badawi 1:20

of some kind

Dr. Norman Swan 1:22

from a variety of

Nadia Badawi 1:22

causes. Absolutely. It's very complex. There's a variety of causes. And about 40% were born prematurely. We're now aware that about 30% have a genetic basis.

Dr. Norman Swan 1:34

Meaning it's hereditary?

Nadia Badawi 1:35

Look, we think that about 1% to 2% of cerebral palsy is strictly hereditary.

Dr. Norman Swan 1:42

So it runs in families.

Nadia Badawi 1:43

Yes. We think that these are new mutations, and we're seeing those same changes in people who have epilepsy and people who have intellectual disability.

Dr. Norman Swan 1:53

And the minority is due to birth trauma.

Nadia Badawi 1:55

Yes. I was very lucky and did my PhD with Fiona Stanley and I also worked with Eve Blair, who started Australia's first registry, the Western Australian.

Why have rates of cerebral palsy fallen in recent years and what interventions are driving the decline?

Nadia Badawi 2:05

And they were among some of the first people in the world to show that despite all our beliefs, most cerebral palsy was not related to a lack of oxygen around the time of birth.

Dr. Norman Swan 2:18

So what you're presenting is it's flatlined for many years, the incidence of cerebral palsy. Yes. And the last few years it's dropped.

Nadia Badawi 2:27

Yes. It's wonderful. It is wonderful. How much has it dropped? It has dropped by one third. One third? One third. It is extraordinary. And at one time we were saying that the rate was as high as one in 400 live births. But when we started the Australian register, which is really the work of all the registers and territories combined, that figure about 10 to 15 years ago was one in 500 live births. And three years ago, one in 625. And now we've looked at these figures right back forward, and it's now one in 700 live births.

Dr. Norman Swan 3:05

And that's an accurate

Nadia Badawi 3:06

measure because

Dr. Norman Swan 3:06

sometimes babies don't get diagnosed with cerebral palsy until they're two,

Nadia Badawi 3:10

for example. Yes, and that's why we are not reporting the numbers till the children are five years of age.

Dr. Norman Swan 3:18

And paediatricians are pretty good at entering the babies in the register.

Nadia Badawi 3:21

Allied health professionals, families, people with cerebral palsy can also put in their own data.

Dr. Norman Swan 3:28

One explanation for the decline is people have got slack and aren't reporting cerebral palsy

Nadia Badawi 3:33

anymore. On the contrary, people are actually reporting more because we're getting much more stringent about reporting cerebral palsy. And also, I also work in the newborn intensive care. And, you know, Australia and New Zealand were very lucky. The whole of the neonatal units get together twice a year. And we're all starting to notice in the last few years we're not seeing as much cerebral palsy as we used to. What is the reason for

Dr. Norman Swan 4:01

the decline?

Nadia Badawi 4:01

Look, it's complex. So for the premature babies, it is possibly what caused them to be premature. It was factors around the time of their birth and care in newborn intensive care. Everything's got much tighter. Are

Dr. Norman Swan 4:15

fewer preterm babies being

Nadia Badawi 4:17

born? No, they're not. And their survival is increasing because, you know, people always said, oh, look, if you have survival increasing, you're going to get higher rates of disability.