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

Lara de Almeida Rodrigues1, Rafael Coelho Magalhães2, Bernat Vinolas Prat3

  • 1Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Insights

A new multicriteria index accurately identifies infants at high risk for cerebral palsy (CP) using key clinical factors. This tool aids in early detection and intervention for high-risk newborns following neonatal intensive care unit (NICU) stays.

Area of Science:

  • Neonatal neurology
  • Pediatric developmental disorders
  • Clinical risk assessment

Background:

  • Cerebral palsy (CP) is a significant concern in high-risk infants.
  • Early identification of CP risk is crucial for timely intervention.
  • Existing methods may not fully capture the multifactorial nature of CP risk in neonates.

Purpose of the Study:

  • To develop and validate a multicriteria index for identifying infants at high risk of cerebral palsy (CP).
  • To incorporate key clinical factors associated with CP into a predictive index.
  • To improve the precision of risk assessment for infants with a history of neonatal intensive care unit (NICU) admission.

Main Methods:

  • An exploratory cross-sectional study included 92 infants discharged from NICUs in Brazil.
  • Infants were assessed using General Movements (GMs) and Hammersmith Infant Neurological Examination (HINE).
  • A multicriteria index integrated factors including TORCHSZ infections, prematurity, birth asphyxia, Apgar scores, seizures, ventilation duration, and specific medications.

Main Results:

  • The developed index demonstrated a moderate positive association with high CP risk (R²=0.20, p<0.0001).
  • Abnormal GMs and HINE results were key indicators of high risk.
  • Significant differences in risk were observed between low- and high-risk groups (p<0.0001) and medium- and high-risk groups (p=0.005).

Conclusions:

  • The multicriteria high-risk CP index effectively identifies infants with CP risk post-NICU admission.
  • Combining clinical factors in the index enhances the identification of high-risk infants.
  • This tool can assist healthcare professionals in making more accurate referrals for early intervention programs.
Abstract

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