Abstract

Background: The importance of studying cerebral palsy comes from the fact that, this disorder imposes huge burden families psychologically, emotionally, financially and socially. Moreover, it imposes a major burden on the National Health System because it is simply a chronic disorder, which needs a continuous care and multiple financial resources. At the same time, it needs collaborative efforts and team work between many parties and organizations for a good management and rehabilitation. In Iraq, risk factors of cerebral palsy have not been explored before. Our study objective was to measure the association between, maternal factors, foetal and early neonatal factors, and occurrence of cerebral palsy among Iraqi children. Postnatal risk factors of cerebral palsy were excluded in our study. Methods: We did a retrospective case-control study in Baghdad-Iraq. The place of study was The Central hospital of Children of Baghdad. Cases and controls were fully investtigated (retrospectively) for the risk factors of cerebral palsy using a self-administered questionnaire. The sample size was 300. Number of cases in our study was 100 while the number of controls in our study was 200. Results and conclusion: 84% of the mothers of Cerebral Palsy children were employed compared to 49% of the mothers of normal children who were employed (P value 0.00). After using a multiple logistic regression model, the final adjusted odd ratios included 6 variables which were, employment of mother (OR 8.05, 95% CI 0.98 - 6.62), Primigravida(OR 0.24, 95% CI 0.10 - 0.60), gender of the child(OR 0.15, 95% CI 0.04 - 0.51 ), asphyxia (OR 10.58, 95% CI 3.59 - 31.21), hypoglycemia (OR 40.99, 95% CI 6.93 - 242.27) and hypocalcaemia (OR 27.91, 95% CI 2.04 - 380.96). Our study came to a conclusion that neonatal asphyxia, hypoglycemia and hypocalcaemia were still the major risk factors for cerebral palsy In Iraq.

Highlights

  • Cerebral palsy (CP) is a symptom complex, rather than a specific disease

  • One more reason of choosing Baghdad city as the study location is that, the Central Hospital of Children in Baghdad is considered as the main hospital which, most of the cases of cerebral palsy in Iraq are referred to, which makes collecting the sample for the study a bit easier process

  • Three variables showed high significance as a risk factor for CP. and hypocalcaemia all showed significant results, Asphyxia (P value of 0.00 OR 10.58, 95% CI 3.59 - 31.2), hypoglycemia (P value 0.00, OR 40.99, 95% CI 6.93 242.270) and hypocalcaemia (P value 0.01, OR 27.92, 95% CI 2.04 - 380.96)

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Summary

Introduction

Cerebral palsy (CP) is a symptom complex, rather than a specific disease. The most recent consensus definition states that cerebral palsy is an “umbrella term covering a group of non-progressive, but often changing, motor impairment syndromes secondary to lesions or anomalies of the brain arising in the early stages of its development”. The traditional definition of cerebral palsy is a non-progressive impairment in movement or posture caused by injury or anomaly of the developing brain [2]. The importance of studying cerebral palsy comes from the fact that, this disorder imposes huge burden families psychologically, emotionally, financially and socially. It imposes a major burden on the National Health System because it is a chronic disorder, which needs a continuous care and multiple financial resources. In Iraq, risk factors of cerebral palsy have not been explored before. Postnatal risk factors of cerebral palsy were excluded in our study. Cases and controls were fully investigated (retrospectively) for the risk factors of cerebral palsy using a self-administered questionnaire. After using a multiple logistic regression model, the final adjusted odd ratios included 6 variables which were, employment of mother (OR 8.05, 95% CI 0.98 - 6.62), Primigravida (OR 0.24, 95% CI 0.10 - 0.60), gender of the child (OR 0.15, 95% CI 0.04 - 0.51), asphyxia (OR 10.58, 95% CI 3.59 - 31.21), hypoglycemia (OR 40.99, 95% CI 6.93 - 242.27) and hypocalcaemia

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