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Predictors of Risk for Cerebral Palsy: A Review
Tanochni Mohanty1, Sibi Daniel Joseph, Pradeep Kumar Gunasekaran
1Department of Pediatric Physiotherapy (Ms Mohanty), JSS College of Physiotherapy, Mysuru, Karnataka, India; Department of Musculoskeletal Physiotherapy (Dr Joseph), Lokmanya Tilak College of Physiotherapy, Navi Mumbai, Maharashtra, India; Department of Pediatrics (Drs Gunasekaran and Saini), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India; Department of Pediatrics (Dr Doreswamy), JSS Medical College and Hospital, Mysuru, Karnataka, India.
Insights
Identifying early predictors for cerebral palsy (CP) is crucial. Key risk factors include low birth weight, extreme prematurity, and specific birth complications, aiding in early diagnosis and intervention.
Area of Science:
- Neurology
- Developmental Pediatrics
- Public Health
Background:
- Cerebral palsy (CP) is a complex developmental disorder affecting movement and posture.
- Early identification of risk factors is essential for timely intervention and improved outcomes.
- Understanding predictors from conception to early infancy can inform preventative strategies.
Approach:
- A systematic literature review was performed across multiple databases.
- Studies were critically appraised using Joanna Briggs Institute and Agency for Health Care Research and Quality guidelines.
- Risk factors for CP were extracted and analyzed from conception through early infancy.
Key Points:
- Low birth weight (<1500 g) and extreme prematurity (gestational age <28 weeks) are significant predictors.
- Periventricular leukomalacia and severe intraventricular hemorrhage (grade 3-4) indicate high risk.
- Birth asphyxia, preeclampsia, preterm premature rupture of membranes, and low Apgar scores (<4 at 1 minute) are critical indicators.
- Absent fidgety movements in early infancy are a strong predictor of CP.
- Twenty-three risk factors were consistently identified across the reviewed studies.
Conclusions:
- Early identification of specific risk factors can significantly improve the diagnostic accuracy for cerebral palsy.
- These predictors, identified from conception to early infancy, are vital for targeted screening and intervention programs.
- Further research into the interplay of these factors may refine preventative measures and enhance long-term outcomes for affected children.
Purpose:
To identify the earliest predictors of risk for diagnosis of cerebral palsy (CP).
Methods:
A comprehensive literature search was conducted using various databases. The publications were reviewed to identify risk factors for CP from conception to early infancy. Studies were critically appraised with Joanna Briggs Institute guidelines for quality appraisal and evaluated for risk of bias using the Agency for Health Care Research and Quality guidelines.
Results:
The initial search yielded 129 studies and 20 studies were included. Forty-seven risk factors for CP were extracted of which several were duplicate terms. The significant risk factors found to be indicative of CP were low birth weight (<1500 g), birth at less than 28 weeks of gestational age, periventricular leukomalacia, grade 3 or 4 intraventricular hemorrhage, preeclampsia, prematurity, an Apgar score of less than 4 at the first minute, birth asphyxia, preterm premature rupture of membrane, and absent fidgety movements.
Conclusion:
Twenty-three factors were consistently reported as predictors of CP.
