Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy
Małgorzata Sadowska1, Beata Sarecka-Hujar2, Ilona Kopyta1
1Department of Pediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland.
Insights
Cerebral palsy (CP) risk factors vary by type. Intraventricular bleeding is a key predictor for tetraplegic CP, highlighting the need for targeted care in at-risk children.
Area of Science:
- Pediatrics
- Neurology
- Developmental Biology
Background:
- Cerebral palsy (CP) is a group of motor disorders resulting from nonprogressive brain abnormalities.
- It is a leading cause of childhood motor disability, with diverse etiologies and presentations that evolve with age.
- Understanding risk factors associated with specific CP types is crucial for early intervention.
Purpose of the Study:
- To investigate how selected risk factors differ across various types of cerebral palsy.
- To identify potential predictors for specific CP classifications.
Main Methods:
- Retrospective analysis of 181 children (aged 4-17) diagnosed with CP.
- Risk factors were categorized into pre-conception/prenatal and perinatal/postnatal groups.
- CP types were classified using Ingram's system; statistical analysis identified significant associations.
Main Results:
- Frequent risk factors included respiratory failure, infections, intraventricular bleeding, and prematurity.
- Pregnancy duration and preterm contractions differentiated CP subgroups.
- Most perinatal/neonatal factors differed significantly between CP types, with intraventricular bleeding independently predicting tetraplegic CP.
Conclusions:
- Cerebral palsy is multifactorial, necessitating close monitoring of at-risk infants.
- Specific risk factors can serve as prognostic indicators for particular CP types.
- Knowledge of risk factor-CP type associations aids pediatricians in managing developmental disorders.
Abstract:
Background: Cerebral palsy (CP) is not a defined, separate disease classification, but a set of etiologically diverse symptoms that change with the child's age. According to the up-to-date definition, CP is a group of permanent but not unchanging disorders of movement and/or posture and motor function, which are due to a nonprogressive interference, lesion, or abnormality of the developing/immature brain. CP is one of the most frequent causes of motor disability in children. The aim of the present study was to analyze whether selected risk factors may vary depending on particular types of CP. Methods: 181 children with CP (aged 4-17 years), hospitalized at the Department of Pediatrics and Developmental Age Neurology in Katowice in the years 2008-2016 were retrospectively analyzed in the present study. The assumed risk factors of CP were divided into two groups: 1-pre-conception and prenatal (mother's age, family history of epilepsy, burdened obstetric history, mother's systemic diseases, pregnancy order, multiple pregnancy, duration of pregnancy, bleedings from the genital tract during gestation, arterial hypertension during pregnancy, infections during pregnancy, preterm contractions, maintained pregnancy, premature rupture of membranes, abruptio placentae, and others), 2-perinatal and postnatal (mode of delivery, birth weight, Apgar score at the first and fifth minute, neonatal convulsions, respiratory failure, infections in neonatal and infant period, and intraventricular bleeding). The division into particular CP types was based on Ingram's classification. Results: The following risk factors were the most frequent in the total group: respiratory failure, infections, intraventricular bleeding, and prematurity. Among the analyzed preconception and prenatal factors, the duration of pregnancy and preterm contractions during pregnancy significantly differentiated the subgroups of patients depending on the type of CP. The prevalence of almost all analyzed perinatal, neonatal, and infant-related risk factors (i.e., birth weight, Apgar score at the first and fifth minute, neonatal convulsions, respiratory failure, infections in neonatal and infant period, and intraventricular bleeding) significantly differed between CP types, apart from the mode of delivery. However, in multivariate regression, only intraventricular bleeding was an independent predictor for tetraplegic CP type when compared to joined extrapyramidal and ataxic types (OR = 2.801, p = 0.028). Conclusions: As CP is a syndrome of multifactorial etiology, the identification of CP risk factors entails the need for careful observation and comprehensive care of children in the risk group. The presence of certain risk factors may be a prognostic indicator for particular types of CP. The knowledge about the association between the risk factor(s) and the CP type could be a very useful tool for pediatricians looking after the child at risk of developmental disorders.
