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Prevalence of cerebral palsy with Gross Motor Function Classification System levels IV and V in children in Israel: a
Orit Blumenfeld1, Hilla Ben-Pazi2, Asher Ornoy3,4
1Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel. orit.blumenfeld@moh.health.gov.il.
Insights
Cerebral palsy prevalence is higher in Arab children in Israel, particularly among Bedouins. Factors like consanguinity and term pregnancies contribute to higher rates in Arabs, while preterm births are more common in Jewish children.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Cerebral palsy (CP) is the leading physical disability in childhood.
- Wheelchair-dependent CP (Gross Motor Function Classification System levels IV-V) represents severe motor impairment.
Purpose of the Study:
- To determine the prevalence of wheelchair-dependent cerebral palsy in Jewish and Arab children in Israel.
- To identify demographic and etiological differences between these population groups.
Main Methods:
- Utilized the Israel National Insurance Institute database to identify children born in 2005-2006 diagnosed with CP.
- Retrieved demographic and clinical data from existing child records.
Main Results:
- Overall CP prevalence was 0.8 per 1000 live births, significantly higher in Arab (1.2:1000) versus Jewish (0.6:1000) children.
- Prevalence was highest among Southern Arab (Bedouin) children (2.8:1000).
- Consanguinity and lower socioeconomic status were more prevalent in Arab children with severe CP. Term pregnancies were more common in Arab CP cases, while extreme preterm births and low birth weight were more frequent in Jewish CP cases.
Conclusions:
- Significant population-based disparities exist in severe cerebral palsy rates and associated risk factors between Jewish and Arab children in Israel.
- Higher CP rates in Arab populations may be linked to consanguinity and genetic factors, particularly in term pregnancies.
- Tailored public health interventions are needed, addressing preterm birth risks in Jewish populations and genetic factors in Arab populations.
Purpose:
Cerebral palsy is the most common physical disability in childhood. Our aim was to study the prevalence of wheelchair-dependent cerebral palsy (equivalent to gross motor function classification system level IV/V) among Jewish and Arab children in Israel and to investigate differences between the children of the two population groups.
Methods:
Children diagnosed with cerebral palsy born in the years 2005-2006 were located through the Israel National Insurance Institute database. Demographic and clinical data were retrieved from children's records.
Results:
Overall prevalence in Israel was 0.8 (0.7-0.9) per 1000 live births. The prevalence was significantly higher among Arabs (1.2:1000) than Jews (0.6:1000; OR = 1.6, 95% CI 1.2-2.1, p = 0.001) and was highest among Arabs in the South (Bedouins) (2.8:1000). Consanguinity among parents and low socioeconomic status were significantly more common among Arab children with wheelchair- dependent cerebral palsy compared with Jews. Higher rates of children with cerebral palsy following term pregnancy were found in Arabs. Extreme preterm births, very low birth weight, and emergent cesarean section were more common among Jews compared with Arabs.
Conclusions:
This study revealed population group differences of cerebral palsy with Gross Motor Function Classification System levels IV and V. Higher rates of cerebral palsy, especially following term pregnancy in the Arab population, may be attributed to consanguinity and genetic factors. There is a need to tailor services to underserved population based on etiology: preterm births and genetic causes for the Jewish and Arab populations, respectively.
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