Related Experiment Video
Updated: Aug 5, 2026
Enhancing the Development and Growth of Infant Cerebral Palsy Rats Using Selective Spinal Manipulations
Published on: February 2, 2024
Long-Term Growth and Neurodevelopmental Outcomes in Children with Cerebral Palsy: A Nationwide Population-Based Study
Sung-Hoon Chung1, Young Hwa Song2,3, Jae Woo Lim2,3,4
1Department of Pediatrics, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea.
Insights
Children with cerebral palsy (CP) experience worsening growth and developmental delays throughout early childhood. Neonatal conditions like hypoxic-ischemic encephalopathy (HIE) and necrotizing enterocolitis (NEC) exacerbate these long-term deficits, highlighting the need for early nutritional support.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Cerebral palsy (CP) is a primary cause of childhood disability, yet long-term growth and developmental data are scarce.
- Population-based studies on CP outcomes and associated perinatal factors are limited, particularly in Asian populations.
Purpose of the Study:
- To determine the prevalence of growth failure and neurodevelopmental delay in Korean children with CP.
- To identify perinatal risk factors associated with these adverse outcomes in children with CP.
Main Methods:
- Nationwide retrospective cohort study using South Korean National Health Insurance Service data (2013-2020).
- Inclusion of 1,256,934 infants born 2013-2015, linked with claims and health screening data.
- Multivariable logistic regression analyzed risk factors for growth failure (<3rd percentile) and developmental delay (K-DST score <-2 SD) at 30-36 and 54-60 months.
Main Results:
- CP prevalence was 0.18%; outcomes worsened over time, with widening developmental disparities.
- Hypoxic-ischemic encephalopathy (HIE) and necrotizing enterocolitis (NEC) showed strong, persistent associations with deficits, independent of CP.
- Bronchopulmonary dysplasia was linked to developmental delay initially but not at later stages; its association with growth failure persisted.
Conclusions:
- Children with CP exhibit significant and increasing somatic growth and neurodevelopmental deficits in early childhood.
- Persistent growth failure in CP patients with HIE or NEC emphasizes the critical need for early, multidisciplinary nutritional interventions.
- Early nutritional support is crucial for mitigating long-term adverse outcomes in children with CP and associated neonatal morbidities.
Abstract:
Background/Objectives: Although cerebral palsy (CP) is a leading cause of childhood disability, population-based data on long-term growth trajectories and domain-specific developmental outcomes remain limited. This study aimed to investigate the prevalence of growth failure and neurodevelopmental delay, along with the associated perinatal risk factors, in Korean children with CP. Methods: We conducted a nationwide, retrospective cohort study using data from the National Health Insurance Service. A birth cohort of 1,256,934 infants born between 2013 and 2015 was linked to claims and infant health screening data, followed through 2020. Longitudinal outcomes were assessed at 30-36 months and 54-60 months. Multivariable logistic regression identified risk factors for growth failure (height/weight/head circumference < 3rd percentile) and developmental delay (K-DST score < -2 SD). Results: The overall prevalence of CP was 0.18%. Outcomes for affected children progressively worsened over time. Specifically, the relative disparity in developmental delay between children with and without CP widened over time, with the adjusted odds ratio increasing from 30-36 to 54-60 months. In the multivariable analysis, CP diagnosis showed the strongest independent association with adverse outcomes. Regarding neonatal morbidities, hypoxic-ischemic encephalopathy (HIE) and necrotizing enterocolitis (NEC) were associated with the most pronounced and persistent deficits across the overall cohort, independently of CP. The association between bronchopulmonary dysplasia and developmental delay was attenuated and no longer significant at 54-60 months, whereas its association with growth failure persisted. Conclusions: Children with CP face profound and widening deficits in somatic growth and neurodevelopment throughout early childhood. Persistent growth failure, particularly in patients with HIE or NEC, underscores the critical need for early multidisciplinary nutritional intervention to mitigate long-term adverse outcomes.
