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Growth during infancy and early childhood in children with cerebral palsy: a population-based study
Kristin Melheim Strand1, Magnus O Dahlseng1, Stian Lydersen2
1Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Insights
Children with cerebral palsy (CP) born small for gestational age (SGA) or with severe motor impairments experience reduced growth. Feeding difficulties in infancy also significantly impact growth in children with CP.
Area of Science:
- Pediatrics
- Neurology
- Developmental Biology
Background:
- Cerebral palsy (CP) affects motor function and can impact overall child development.
- Growth patterns in children with CP are variable and influenced by multiple factors.
- Understanding growth trajectories is crucial for early intervention and management.
Purpose of the Study:
- To characterize growth patterns in infants and young children diagnosed with cerebral palsy.
- To identify factors associated with deviations in growth among children with CP.
Main Methods:
- A cohort of 104 children with CP, born at ≥36 weeks gestation (2002-2010), was analyzed.
- Growth data (weight, height, head circumference) were prospectively collected from birth to 5 years.
- Standard deviation (SD) scores (z-scores) were calculated to assess growth parameters against normative data.
Main Results:
- Children born non-small for gestational age (non-SGA) or with mild CP (GMFCS I-II) exhibited normal weight and height growth.
- Children born SGA or with severe CP (GMFCS III-V) showed significantly reduced growth (p<0.001).
- Infant feeding difficulties were linked to reduced growth throughout early childhood; SGA infants had the most severe head circumference reduction.
Conclusions:
- Mild CP does not impede normal growth until age 5, but severe CP and SGA status are associated with growth deficits.
- Infant feeding difficulties and being born SGA are critical predictors of impaired growth in children with CP.
- Monitoring growth is essential, especially for high-risk infants with CP, to guide nutritional and therapeutic interventions.
Aim:
To describe growth in infancy and early childhood in children with cerebral palsy (CP).
Method:
One hundred and four children with CP born at minimum 36 weeks' gestation in 2002 to 2010 were included. Prospectively collected growth data were requested from public health clinics. We calculated standard deviation (SD) scores (z-scores) for weight and height for 12 set age points for each child from birth to 5 years, and for head circumference from birth to 12 months.
Results:
Children with CP had normal growth in weight and height if they were born non-small for gestational age (non-SGA) or had mild motor impairments (i.e. Gross Motor Function Classification System [GMFCS] I-II), whereas children born SGA or with severe motor impairments (GMFCS III-V) had reduced growth (p<0.001). Children with feeding difficulties in infancy had reduced growth in weight and height throughout early childhood, while children without feeding difficulties had normal growth. Head circumference growth decreased most severely among children born SGA, who had mean z-scores of -3.0 (95% confidence interval [CI] -3.7 to -2.2) at 1 year.
Interpretation:
Children with mild CP had normal growth in weight and height until 5 years, and in head circumference during infancy. Feeding difficulties in infancy and being born SGA were strongly associated with reduced growth.
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