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Published on: February 2, 2024
Growth patterns in a population of children and adolescents with cerebral palsy
Steven M Day1, David J Strauss, Pierre J Vachon
1Life Expectancy Project, San Francisco, California, USA. Day@Life Expectancy.com
Insights
Growth charts for children with cerebral palsy (CP) show significant differences compared to the general population, especially for those with lower functional abilities. Feeding tubes were linked to higher weight and height in severely impaired groups.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Clinical Nutrition
Background:
- Children and adolescents with cerebral palsy (CP) often experience growth deviations.
- Accurate growth monitoring is crucial for identifying health issues in this population.
- Existing growth charts may not adequately represent individuals with CP across diverse functional levels.
Purpose of the Study:
- To establish normative growth centile charts for height and weight in children and adolescents with cerebral palsy (CP).
- To compare growth patterns of individuals with CP to the general US population.
- To identify potential clinical applications of these specialized growth charts.
Main Methods:
- Utilized a large dataset of 141,961 height and weight measurements from 24,920 patients with CP (1987-2002).
- Determined height and weight centiles stratified by age, sex, and five functional ability levels.
- Compared CP growth centiles against Centers for Disease Control and Prevention (CDC) charts.
Main Results:
- Growth centiles for height and weight in CP patients closely mirrored the general population for the highest functioning groups.
- Substantial lags in height and weight centiles were observed in lower functioning CP groups.
- Individuals with CP utilizing gastrostomy tubes showed increased height and weight centiles (2-5 kg higher for weight) compared to non-tube-fed peers in the lowest functioning categories.
Conclusions:
- Developed specialized growth charts for children and adolescents with CP, categorized by functional ability.
- These charts can aid in the early detection of nutritional or metabolic challenges.
- Growth patterns in CP vary significantly with functional status, highlighting the need for tailored monitoring tools.
Abstract:
This study examined growth of children and adolescents with cerebral palsy (CP) who received services from the California Department of Developmental Services from 1987 to 2002. In all, 141 961 measurements of height and weight were taken from 24920 patients with CP (14103 males, 10817 females). Centiles of weight and height were determined by age, sex, and five levels of functional ability ranging from fully ambulatory to unable to walk, crawl, or feed self, and fed via gastrostomy tube. Resulting charts of height and weight centiles were compared with Centers for Disease Control and Prevention weight and height charts for the general population of the US. Centiles of height and weight of patients with CP were close to those of the general population for the highest functioning groups with CP, but lagged substantially for other groups. Presence of a feeding tube was associated with greater height and weight in the lowest functioning groups, with centiles for weight being 2 to 5 kg higher for those with gastrostomy tubes. The charts may assist in early identification of nutritional or metabolic difficulties beyond what might be expected for patients with similar functional disabilities.
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