Abstract
Introduction Cerebral palsy is the most common neurologic disorder of childhood with lifelong implications in majority of patients. Knowledge of the determinants of cerebral palsy is important for accurate mobilization of resources in obstetric, perinatal, and infant care besides implementation of prevention systems. In Ethiopia, however, this knowledge gap exists as there are no published studies on determinants of cerebral palsy in the country. Objective To assess the determinants of cerebral palsy in pediatric patients attending Ayder Comprehensive Specialized Referral Hospital between April 2019 and August 2019. Methods An unmatched case-control study was conducted among 50 pediatric cerebral palsy patients and 100 controls, pediatric patients without cerebral palsy or other motor or central nervous system illnesses, attending Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia. The data were analyzed using SPSS version 27. Results Significant factors were operative vaginal delivery (AOR: 9.49, 95% CI: 1.31–68.88), central nervous system infections (AOR: 0.02, 95% CI: 0–0.58), neonatal admissions (AOR: 0.13, 95% CI: 0.03–0.61), and unknown maternal education status (AOR: 18.64, 95% CI: 2.15–161.73). Conclusion Operative vaginal delivery, central nervous system infections in infancy, neonatal hospital admissions, and unknown maternal education status were found to be significant determinants for cerebral palsy. This knowledge aids focused hospital and regional health bureau development and implementation of prevention strategies for cerebral palsy, besides improvement of obstetric and neonatal healthcare services, and provides baseline data to the scientific community for further research.
Highlights
Cerebral palsy is the most common neurologic disorder of childhood with lifelong implications in majority of patients
In the fully adjusted model (Table 4), operative vacuumassisted delivery (AOR: 9.49, 95% confidence interval (CI): 1.31–68.88), unknown maternal education status (AOR: 18.64, 95% confidence interval (95% CI): 2.15–161.73), CNS infection in infancy (AOR: 0.02, 95% CI: 0–0.58), and neonatal admission (AOR: 0.13, 95% CI: 0.03–0.61) remained statistically significant
Is is consistent with another study carried out in India by Sharma et al [39], which showed a higher prevalence of cerebral palsy (CP) in patients with higher birth order but was at variance with the findings of MacLennan et al [2], who found in their study that patients with CP were more among lower birth order patients. e implication of our finding could be related to younger mothers, who have higher-order birth without adequate knowledge of pregnancy-related complications, resulting in delayed health-seeking behavior compared to mothers with higher parity
Summary
Cerebral palsy is the most common neurologic disorder of childhood with lifelong implications in majority of patients. Central nervous system infections in infancy, neonatal hospital admissions, and unknown maternal education status were found to be significant determinants for cerebral palsy. A Ghanaian study demonstrated that severe neonatal hyperbilirubinemia was Neurology Research International the most significant and preventable risk for the development of CP [23]. Postnatal causes such as perinatal asphyxia, bilirubin encephalopathy, intracranial infections, ischemic stroke, and congenital brain malformations have been identified as causative factors in other African studies as well [21, 24,25,26]. Even within resource-limited settings as are found in subSaharan Africa, one might anticipate substantial heterogeneity in the occurrence of risk factors for CP [18, 20]. is variability in risk factors necessitates context-specific analyses of CP drivers for the effective management and use of resources
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