Abstract
BackgroundMoldova is ranked as one of the countries in Europe with the lowest income per capita and with a relatively high infant and maternal mortality rate. Information on neurodisabilities in general is limited, and regarding cerebral palsy (CP) in particular, it is completely lacking. The aim of this study was therefore to make a crude estimate of the prevalence of CP and to describe subtypes and the severity of motor impairments and associated problems in this country.MethodsChildren with CP born 2009–2010, attending the National Hospital Institute of Mother and Child, the reference hospital for ~ 75% of children in Moldova with neurological disabilities, were identified from medical records.ResultsAmong 207 children with CP (estimated prevalence 3.4 per 1000 live births), 185 (mean age 7.3 years; 36% girls) had detailed information. Thirty seven (20%) children had spastic unilateral, 113 (61%) spastic bilateral, 22 (12%) dyskinetic and 9 (5%) children had ataxic CP. The subtype was unclassified in four children. Among all children, 93 (51%) had epilepsy, 109 (59%) intellectual disability, 42 (23%) severe vision and 10 (5%) hearing impairments while 84 (45%) children had severe speech impairments. Fifty-two (28%) children were born prematurely, and 46 (25%) had Apgar scores below 7 at five minutes.ConclusionCompared to other European studies, the distribution of CP subtypes was different in Moldova. Moreover, the estimated prevalence, the proportions with severe motor and associated impairments and of children born at term were higher in Moldova while the proportion with low Apgar did not differ. The findings may suggest different etiological pathways causing CP in Moldova than in other European countries. A national register is warranted for quality assurance and improvement.
Highlights
Moldova is ranked as one of the countries in Europe with the lowest income per capita and with a relatively high infant and maternal mortality rate
The aim of this study is to describe the panorama of cerebral palsy (CP) in Moldova with emphasis on CP subtypes, the severity of the motor impairments and the occurrence of associated impairments, as well as how these clinical characteristics relate to perinatal risk factors
The total number of live births during 2009 and 2010 in Moldova was 81,277, and a crude estimate of CP prevalence would be 3.4 per 1000 live births if the children in this study were recruited from 75% of the birth population
Summary
Moldova is ranked as one of the countries in Europe with the lowest income per capita and with a relatively high infant and maternal mortality rate. Considering the significant differences in perinatal and infant mortality between high- and low-income countries, it may seem paradoxical that the prevalence of CP has been reported to be similar, at around 2–3 per 1000 live births both in developing countries [2, 3] and in developed countries [4, 5]. In studies describing the panorama of CP, ascertainment of cases is a challenge even in developed countries [5] In this regard, it is noteworthy that other studies in developing countries have reported CP prevalence between 3.4 and 4.5 per 1000 live births [3, 7]
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