Factors Associated with High Risk of Cerebral Palsy: Development of a Multicriteria Index

To develop a multicriteria index with the main factors associated with high risk of cerebral palsy (CP).

Exploratory cross-sectional study. Ninety-two infants, mean age 94.8 (±13.5) days, discharged from neonatal intensive care units (NICU) in Brazil, were included, and assessed using the General Movements (GMs) and Hammersmith Infant Neurological Examination (HINE). The multicriteria index incorporated factors such as infections from the toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis, and zika virus (TORCHSZ), prematurity, birth asphyxia, Apgar score, seizures, duration of mechanical ventilation, corticosteroid and magnesium sulfate medications, therapeutic hypothermia, and caffeine. Validation included the Pearson correlation, simple linear regression analysis, and one-way analysis of variance (ANOVA), with Tukey's post hoc test.

The multicriteria index showed a positive and moderate association with high risk of CP (R²=0.20, p < 0.0001), indicated by abnormal GMs and HINE results. Significant differences between the low- and high-risk groups (p < 0.0001) and between the medium- and high-risk groups (p = 0.005) of CP were found.

The multicriteria high risk CP index, developed by combining clinical factors, enabled the identification of high-risk infants with CP and a history of NICU admission. These findings can support healthcare professionals in making more precise referrals for early intervention.