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Nutritional status and functions in children with cerebral palsy at different gestational ages
Hongmei Tang1, Qihong Wu1, You Wang1
1Department of Rehabilitation Guangzhou Women and Children's Medical Center Guangzhou Medical University Guangzhou Guangdong China.
Insights
Malnutrition is common in children with cerebral palsy (CP), especially those born preterm. Poorer nutritional status in preterm infants with CP correlates with reduced motor function and daily living skills.
Area of Science:
- Pediatrics
- Neurology
- Nutritional Science
Background:
- Malnutrition is prevalent in children with cerebral palsy (CP), negatively impacting rehabilitation.
- Preterm birth is a significant risk factor for CP, but its link to malnutrition and functional status in affected children is not well understood.
Purpose of the Study:
- To examine how gestational age influences the relationship between nutritional status and functional abilities in children with CP.
- To identify specific gestational age thresholds associated with malnutrition and functional deficits in children with CP.
Main Methods:
- A cohort of 575 children with CP was analyzed, categorized by gestational age (<28, 28-32, 33-36, ≥37 weeks).
- Nutritional status was assessed using standard growth metrics (z-scores).
- Gross motor function (GMFCS), eating/drinking ability (EDACS), and activities of daily living (ADL) were evaluated.
Main Results:
- 49% of participants were born preterm, and 40.4% had malnutrition.
- Nutritional status significantly correlated with gestational age and all functional measures (GMFCS, EDACS, ADL).
- Children born before 32 weeks of gestation showed an independent association with moderate undernutrition (OR 4.61 for <28 weeks, OR 2.71 for 28-32 weeks).
Conclusions:
- Nutritional status is significantly linked to motor function, feeding, and ADL in preterm children with CP, especially those born before 32 weeks.
- These findings highlight the need for tailored rehabilitation strategies for preterm infants with CP to address nutritional and functional deficits.
Importance:
Malnutrition is highly prevalent in children with cerebral palsy (CP) and adversely affects rehabilitation outcomes. Preterm birth is a major risk factor for CP, yet the relationship between functional status and malnutrition in preterm children with CP remains unclear.
Objective:
To investigate the effect of gestational age on the association between nutritional status and function levels in children with CP.
Methods:
This study included 575 children with CP enrolled between July 2020 and December 2021. Participants were stratified into four groups by gestational age at birth: <28, 28-32, 33-36, and ≥37 weeks. Nutritional status was assessed using weight-for-age, weight-for-height, height-for-age, and body mass index-for-age z-scores. Gross motor function, eating/drinking ability, and activities of daily living (ADL) were evaluated using Gross Motor Function Classification System (GMFCS), Eating And Drinking Ability Classification System (EDACS), and ADL scales, respectively.
Results:
Of the 575 children, 49.0% were born preterm, and 40.4% were categorized as malnutrition. Nutritional status was significantly correlated with gestational age (Kendall's Tau-b = 0.13, P < 0.01) and all functional measures (P < 0.01). Gestational age was correlated with ADL level (Kendall's Tau-b = 0.11, P < 0.01). Stratified analyses revealed significant correlations between nutritional status and GMFCS, EDACS, and ADL levels in both the 28-32-week and ≥37-week groups (all P < 0.01). Multinomial logistic regression analysis further demonstrated that gestational age <32 weeks was independently associated with moderate undernutrition (<28 weeks: OR: 4.61, 95% CI: 1.83-11.63, P = 0.001; 28-32 weeks: OR: 2.71, 95% CI: 1.56-4.72, P < 0.001).
Interpretation:
Nutritional status in preterm children with CP, particularly those born before 32 weeks of gestation, correlates significantly with motor function, feeding ability, and daily living skills. These findings may inform the development of individualized rehabilitation strategies for this high-risk population.
