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Linear growth velocity in children with cerebral palsy
1Pediatrics, University of Utah, USA.
Insights
Children with cerebral palsy (CP) exhibit slower linear growth than their peers. Factors like younger age, nutritional risk, cognitive impairment, and non-ambulatory status contribute to poor growth in these children.
Area of Science:
- Pediatrics
- Child Development
- Growth Disorders
Background:
- Children with cerebral palsy (CP) often present with unique growth patterns.
- Understanding linear growth velocity is crucial for monitoring health and development in children with CP.
Purpose of the Study:
- To evaluate linear growth velocity in prepubertal children with cerebral palsy (CP).
- To identify risk factors associated with poor linear growth in this population.
Main Methods:
- Retrospective analysis of a prospectively collected anthropometric database.
- Comparison of growth velocity z scores (Gvz) with published prepubertal norms.
- Statistical analysis to identify correlations between Gvz and various clinical factors.
Main Results:
- The mean Gvz for children with CP was -0.97 ± 1.9, indicating slower growth than expected.
- Boys exhibited slower growth than girls (mean Gvz = -1.5 vs. -0.3).
- Younger age (under 2 years), nutritional risk, cognitive impairment, and non-ambulatory status were significant risk factors for poor linear growth.
Conclusions:
- Prepubertal children with CP demonstrate significantly slower linear growth compared to age- and sex-based standards.
- Growth patterns in children with CP are influenced by sex, age, cognitive function, mobility, and nutritional status.
- Further research is necessary to fully elucidate the factors contributing to impaired linear growth in children with CP.
Abstract:
Retrospective analysis of an anthropometric database collected prospectively in children with cerebral palsy (CP) was carried out to evaluate linear growth velocity and identify risk factors for poor linear growth. Growth velocity measures were compared with published norms for prepubertal growth velocity and z scores were calculated. Mean growth velocity z score (Gvz) was -0.97+/-1.9. Boys grew more slowly than girls (mean Gvz = -1.5+/-1.9 versus -0.3+/-1.7 P = 0.003). Gvz did not correlate with type of CP or presence/absence of microcephaly. Young age was a risk factor for poor linear growth (mean Gvz = -2.40+/-2.6 for children under 2 years of age versus -0.76+/-1.9 ages 2 to 6 and -0.77+/-1.6 ages 6 to 10, P = 0.04). Children at nutritional risk (triceps skinfold thickness < or =55%) grew poorly (mean Gvz = -1.46+/-1.5 versus -0.30+/-1.8, P = 0.01). For children over 2 years, those with cognitive impairments grew more slowly than those with normal cognition (mean Gvz = -1.25+/-1.9 versus -0.12+/-1.8, P = 0.02) and non-ambulatory children grew more slowly than ambulatory children (mean Gvz = -1.20+/-1.5 versus -0.35+/-1.9, P = 0.03). Prepubertal children with CP grow more slowly than expected compared with age- and sex-based standards. Sex, age, cognitive impairment, ambulatory status, and nutritional state are factors which may contribute to slow growth. These results add to the growing data that children with CP have unique growth patterns. Further study is needed to clarify the factors which contribute to poor linear growth in this population.