Cerebral palsy: potential risk factors and functional status among children under three years, a case-control study
Morteza Haramshahi1, Vahideh Toopchizadeh2, Samira Pourzeinali3
1Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Identifying risk factors for cerebral palsy (CP) is crucial for prevention. This study found that shorter pregnancy duration, low birth weight, and pregnancy complications are significant risk factors for CP in children.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Cerebral palsy (CP) is a common childhood motor-postural disorder resulting from early brain damage.
- CP poses a significant public health burden, necessitating research into its causes and associated conditions.
Purpose of the Study:
- To investigate potential risk factors associated with cerebral palsy.
- To identify common disorders and developmental issues co-occurring with CP.
Main Methods:
- A case-control study involving 46 children with CP and 175 healthy controls under three years old.
- Data collection included maternal medical history, perinatal factors, CP type, comorbidities, GMFCS, and ASQ.
- Statistical analysis employed Chi-square, Independent t-test, and Binary logistic regression using SPSS.
Main Results:
- Spastic CP was the predominant type (82.9%), with quadriplegia being the most common limb involvement (54.3%).
- Severe functional impairment (GMFCS levels 4-5) affected 39.3% of CP cases.
- Key comorbidities included inability to walk (31.4%), speech delay (22.9%), and epilepsy (11.4%).
- Children with CP exhibited abnormal development in gross motor (82.9%), problem-solving (68.6%), and communication (54.3%).
- Risk factors identified were shorter pregnancy duration (p=0.023), low birth weight (<2500g, p=0.002), and pregnancy complications (aOR=3.06-4.8).
Conclusions:
- CP is associated with significant motor, speech, and developmental challenges.
- Preventive measures targeting identified risk factors like pregnancy complications and birth weight are essential.
Background:
Cerebral palsy (CP) is one of the most common motor-postural disorders in childhood. It occurs due to impairment in the developing brain-before, during, or after birth-and has a significant burden on the public health system. This study aimed to investigate the potential risk factors and detect the associated CP-related disorders.
Methods:
This case-control study was conducted on 46 children with CP and 175 matched healthy children less than three years old who referred to the Children's Hospital, Tabriz, Iran in 2022. Then, a checklist related to the mother's medical history during current and previous pregnancies, a questionnaire related to perinatal factors of the newborn, types of CP, concurrent disorders, the Gross Motor Function Classification System (GMFCS), and Age and Stage Questionaire (ASQ) were completed. Data was analyzed using Statistical Package for the Social Sciences) SPSS(-21 software by descriptive and analytical statistics consisted of Chi-square, Independent t-test, and Binary logistic regression.
Results:
Finally, 35 children with CP and 122 healthy children completed the study and were analyzed. The mean (standard deviation: SD) age of children in the CP group was 15.3 (6.2) and in the healthy group was 14.4 (6.6) months (p = 0.635). Spastic CP (82.9%) was the common type, and the most common prevailing form of the involved limb was quadriplegia (54.3%). The severity of the functional disorder in 39.3% of CP cases was at levels 4 and 5 (severe form). The most prevalent comorbidities were inability to walk (31.4%), speech delay (22.9%), epilepsy (11.4), and strabismus (8.6%). Children with CP had abnormal development in gross motor (82.9%), problem-solving (68.6%), personal-social (65.7%), fine motor (60%), and communication (54.3%). Moreover, duration of pregnancy (p = 0.023), birth weight lower than 2500 g (p = 0.002), problems in the current pregnancy [adjusted odds ratio (aOR) [95% CI]: 3.06 (1.87 to 8.54); p = 0.013] and problems in previous pregnancy ([aOR (95% CI): 4.8 (1.6 to 14.2); p = 0.005) were potential risk factors.
Conclusion:
Due to accompanying movement, vision, and speech problems, especially high developmental disorders in children with CP, necessary measures to prevent the identified risk factors are very important.
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