Nutritional aspects in patients with cerebral palsy: A multicenter observational study in Spain
Ruth García-Romero1, Ramón Cancho Candela2, José Luis Peña Segura3
1Gastroenterología Pediátrica, Hospital Infantil Miguel Servet, Zaragoza, Spain.
Insights
Spanish children with cerebral palsy (CP), particularly those with severe motor impairment, face significant risks of malnutrition and gastrointestinal issues. These children often require specialized nutritional support to manage their health effectively.
Area of Science:
- Pediatrics
- Neurology
- Nutrition Science
Background:
- Cerebral palsy (CP) is a group of motor disorders impacting swallowing and food intake, leading to poor nutritional status.
- Understanding the specific clinical and nutritional profiles of Spanish children with CP is crucial for targeted interventions.
Purpose of the Study:
- To describe the clinical and nutritional characteristics of Spanish children diagnosed with cerebral palsy.
- To identify risk factors and comorbidities associated with CP in this population.
Main Methods:
- A multicenter observational study was conducted involving 112 children aged 4-14 years with CP.
- Data collected included sociodemographics, clinical status, anthropometric measurements, schooling, school nutrition, nutritional support, and gastrointestinal comorbidities.
Main Results:
- Children with severe CP (Gross Motor Function Classification System [GMFCS] levels IV-V) showed significantly lower anthropometric z-scores compared to those with GMFCS levels I-III.
- A higher proportion of children with GMFCS IV-V had dysphagia, constipation, gastroesophageal reflux, and attended special education schools.
- Severe motor impairment was strongly associated with poorer nutritional status and increased gastrointestinal comorbidities.
Conclusions:
- Spanish children with CP, especially those with severe motor impairment, are at high risk for malnutrition.
- Gastrointestinal comorbidities are prevalent in this population and necessitate appropriate nutritional support strategies.
- Early identification and management of nutritional deficits and GI issues are vital for improving health outcomes in children with CP.
Introduction:
Cerebral palsy (CP) encompasses a group of motor disorders that can result in swallowing difficulties, affecting food intake and contributing to poor nutritional status. The goal of the study was to describe the clinical and nutritional characteristics of Spanish children with CP.
Methods:
Multicenter observational study conducted in children aged 4-14 years with a diagnosis of CP. For every patient, we collected data on sociodemographic and clinical characteristics as well as anthropometric measurements, schooling modality, nutrition received at school, nutritional support and gastrointestinal comorbidities.
Results:
The sample included a total of 112 patients with a mean age of 9.2 years old. The majority (70.5%) had been classified as Gross Motor Function Classification System (GMFCS) level IV or V. Compared to children classified as GMFCS level I, II or III, the group of children with GMFCS level IV/V had significantly lower mean z scores in body weight, height, weight-to-height ratio, body mass index and upper arm circumference and a significant lower mean arm area. A higher proportion of patients with GMFCS level IV/V attended special education schools compared to patients classified as level I to III (68.4% vs. 12.1%; P < .0001). A higher proportion of children classified as level IV/V compared to children classified as levels I to III presented dysphagia (62.0% vs. 15.2%; P < .0001), constipation (51.9% vs. 27.3%, P = .0218) and gastroesophageal reflux (31.6% vs. 3.0%; P = .0005).
Conclusions:
Our study shows that Spanish children with CP, especially those with severe motor impairment, are at risk of malnutrition, present gastrointestinal comorbidities and require nutritional support.
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