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Usefulness of Cerebral Palsy Curves in Mexican Patients: A Cross-Sectional Study

Carlos P Viñals-Labañino¹, Ana E Velazquez-Bustamante¹, Silvia I Vargas-Santiago¹

¹1 Pediatric Rehabilitation Department, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarrra, Tlalpan, Mexico City, Mexico.

Journal of Child Neurology

|March 12, 2019

Insights

Growth charts for children with cerebral palsy (CP) should not be compared to healthy populations. Using CP-specific growth charts accurately identifies nutritional status in CP patients, unlike standard CDC charts.

Area of Science:

Pediatrics
Neurology
Growth and Development

Background:

Cerebral palsy (CP) is a group of nonprogressive disorders affecting fetal or infant brain development, leading to movement and posture impairments.
Children with CP exhibit unique growth patterns that differ significantly from the healthy pediatric population.
Standard growth charts, such as those from the Centers for Disease Control and Prevention (CDC), may inaccurately assess nutritional status in children with CP.

Purpose of the Study:

To evaluate the efficacy of using cerebral palsy-specific growth charts versus standard CDC growth charts for assessing growth parameters in a pediatric CP population.
To compare growth metrics (height, weight, BMI) of Mexican CP patients with US CP patients.
To investigate the correlation between body mass index (BMI) and functional classification systems in children with CP.

Main Methods:

A study involving 452 children (186 female, 266 male) diagnosed with cerebral palsy.
Comparison of growth data using both CDC growth charts and specialized cerebral palsy growth charts.
Statistical analysis including t-tests for group comparisons and correlation analysis (Spearman's rho) for functional assessments.

Main Results:

Cerebral palsy-specific growth charts showed statistically significant differences compared to CDC charts (P = .00001).
Using CDC charts, 40.71% of CP patients were below the 5th percentile, versus only 5.5% when using CP-specific charts.
Negative correlations were observed between BMI and functional systems: EDACS (rho = -0.4798), CFCS (rho = -0.4353), and GMFCS (rho = -0.3584), all with P = .00001.

Conclusions:

Standard pediatric growth charts tend to overestimate underweight status in children with cerebral palsy.
Cerebral palsy-specific growth charts are recommended as a more accurate reference for monitoring growth in this population.
A functional profile, including communication, motor function, and feeding efficiency, can be established based on BMI in cerebral palsy patients.

Read full analysis

Abstract:

Cerebral palsy describes a group of movement and posture disorders that cause activity limitation, and are attributable to nonprogressive disorders that occur in the fetal or infant brain. The growth of these children should not be compared with those of the healthy population. We studied 452 children, 186 female and 266 male. We compared the results in 2 growth charts, Centers for Disease Control and Prevention (CDC) and cerebral palsy, and the results were statistically significant ( P = .00001). With the CDC charts, 40.71% of the patients were below the 5th percentile and only 5.5% of them when we used the charts for cerebral palsy patients. The Mexican cerebral palsy patients were similar to US cerebral palsy patients when we compared height ( P = .4075) and body mass index (BMI) ( P = .4075). Only the weight was found to be different ( P = .00001). All the correlation indexes were negative: Eating and Drinking Ability Classification System (EDACS)-BMI (rho = -0.4798) ( P = .00001), Communication Function Classification System (CFCS)-BMI (rho = -0.4353) ( P = .00001), and Gross Motor Function Classification System (GMFCS)-BMI (rho = -0.3584) ( P = .00001). The growth charts of the healthy pediatric population tend to overestimate the underweight. We propose to use cerebral palsy charts as a reference in our patients. It is possible to determine a functional profile (communication, gross motor function and safety, and feed efficiency) for the cerebral palsy population based on their BMI.

Keywords:

cerebral palsy developmental delay disability quality of life rehabilitation

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