Nutritional status and clinical characteristics of paediatric patients with cerebral palsy in Turkey

Abstract

Objective: To evaluate the prevalence of malnutrition and aetiology of cerebral palsy (CP) among paediatric patients in Turkey. Methods: This was a cross-sectional, non-interventional survey study with data from 1108 paediatric CP patients collected between October 2015 and July 2016. Male or female children with CP aged ≥1 and <19 years who are current paediatric neurology outpatients were enrolled from 20 sites in Turkey. Genetic disorders, CP-unrelated chronic diseases and CP of postnatal origin were exclusion criteria. Results: Of the children; 451(40.7%) were female; the mean age was 7.2±0.1 years. Mean age at CP diagnosis was 30.6±0.9 months. 586(52.9%) of the children were delivered via Caesarean section, parental consanguinity was a factor in 286(25.8%) of the patients, 105(9.5%) of the patients were part of multiple birth, and 49(4.4%) patients had siblings with CP. Mean gestational age was 35 weeks. The three most common CP aetiologies were asphyxia (62.5%), low birth weight (45.6%), and prematurity (44.5%); CP types were spastic (87.5%), dyskinetic/dystonic (6.0%), and ataxic-hypotonic (4.1%). The affected parts of the body for these paediatric CP patients were quadriplegic (54.0%), diplegic (31.2%) and hemiplegic (13.7%). Mean z-scores for weight-for-age, height-for-age, head circumference-for-age, using Neyzi growth standards, at birth were -2.11±0.07, -1.28±0.14-, and, -0.83±0.24; whereas, at the time of enrolment, mean z-scores were -1.95±0.07, -1.7±0.07, and -2.83±0.07, respectively. Gomez classification of malnutrition derived from weight-for-age percentile revealed that 86.7% had 3rd degree (percentile<60), 4.6% had 2nd degree (percentile60-75) and 3.0 had 1st degree (percentile76-90) of malnutrition. According to physician questionnaires, 634(57.2%) of sampled paediatric CP patients were malnourished, and the physicians considered nutritional management as a priority. Conclusion: This cross-sectional survey provided valuable information about malnutrition and paediatric cerebral palsy patients in Turkey. This data may be utilized for future proactive strategies in the prevention and treatment of malnutrition in this population.