Risk Factors For Cerebral Palsy Research Articles

Protocol for hospital based-surveillance of cerebral palsy (CP) in Hanoi using the Paediatric Active Enhanced Disease Surveillance mechanism (PAEDS-Vietnam): a study towards developing hospital-based disease surveillance in Vietnam

IntroductionThe epidemiology, pathogenesis, management and outcomes of cerebral palsy (CP) in low-income and middle-income countries including Vietnam are unknown because of the lack of mechanisms for standardised collection of data....

Dental caries and related risk factors in Saudi cerebral palsy children.

Objective:To determine caries experience and related risk factors in cerebral palsy (CP) children.Methods:Random sample of CP children was examined for dental caries and oral hygiene. Questionnaire was utilized for information about caries risk factors. This cross-sectional study was conducted in Riyadh from December 2014 to May 2015.Results:Fifty-two CP children were examined with mean age of 6.3±2.7 years. Only one (1.9%) child out of the 52 had no clinical caries. Combined (dmft plus DMFT) mean caries score among study sample was 9.98±3.99. Older children had significantly higher mean caries scores (11.5±3.34) than younger children (8.86±4.1, p=0.017). The CP children with good oral hygiene had lowest mean caries score (5.8±7.32) as compared to those with fair (9.72±3.3) and poor (11.55±3.05) oral hygiene (p=0.012). Those children whose first dental visit was for routine check-up had significantly (p=0.02) lower mean caries scores (7.33±4.65) than those who made their first visit due to dental problem (11.57±4.15). Similarly, those who had topical fluoride applications by dentist had significantly (p=0.003) lower mean caries scores (8.67±4.14) than those with no topical fluoride application (11.9±2.89).Conclusion:The studied CP children had very high caries experience and poor oral hygiene. There was strong association between the high caries experience and poor oral hygiene.

Antenatal and intrapartum interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews.

Antenatal and intrapartum interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews.

Risk Factors for Cerebral Palsy in Children in Botswana

BackgroundAlthough cerebral palsy is reported to have a higher prevalence in low-resource settings, there are few studies describing risk factors for cerebral palsy in these settings. A better understanding of the unique risk factors affecting children with cerebral palsy in low-resource settings could optimize both resource allocation and preventative strategies. MethodsA case-control study comparing children with cerebral palsy at ages two to 18 years with age-matched healthy control subjects was conducted between 2013 and 2014 at a referral center in Gaborone, Botswana. Study participants were enrolled from inpatient and outpatient settings, and data were collected through caregiver interviews, review of medical records, and physical examination of subjects. Risk factors were evaluated using conditional logistic regression models. ResultsWe studied 56 subjects with cerebral palsy and 56 age-matched control subjects. Significant risk factors for cerebral palsy included a history of serious neonatal infection (odds ratio 15.0, P = 0.009), complications during delivery (odds ratio 13.5, P < 0.001), and maternal human immunodeficiency virus (HIV) infection (odds ratio 3.5, P = 0.03). Maternal HIV infection remained a significant risk factor after adjusting for potential confounders and covariates (adjusted odds ratio 13.2, P = 0.05). ConclusionsMajor risk factors for cerebral palsy in Botswana differ from those described in high-resource settings. Modifiable risk factors such as maternal HIV infection should be targeted as a potential strategy to reduce the incidence of cerebral palsy in Botswana. Further studies are necessary to determine optimal preventative and treatment strategies in this population.

Chorioamnionitis in the Development of Cerebral Palsy: A Meta-analysis and Systematic Review.

Chorioamnionitis (CA) has often been linked etiologically to cerebral palsy (CP). To differentiate association from risk of CA in the development of CP. PubMed, Cochrane Library, Embase, and bibliographies of original studies were searched by using the keywords (chorioamnionitis) AND ((cerebral palsy) OR brain). Included studies had to have: (1) controls, (2) criteria for diagnoses, and (3) neurologic follow-up. Studies were categorized based on: (1) finding incidence of CP in a CA population, or risk of CP; and (2) incidence of CA in CP or association with CP. Two reviewers independently verified study inclusion and extracted data. Seventeen studies (125 256 CA patients and 5 994 722 controls) reported CP in CA. There was significantly increased CP inpreterm histologic chorioamnionitis (HCA; risk ratio [RR] = 1.34, P < .01), but not in clinical CA (CCA). Twenty-two studies (2513 CP patients and 8135 controls) reported CA in CP. There was increased CCA (RR = 1.43, P < .01), but no increase in HCA in preterm CP. Increased HCA was found (RR = 4.26, P < .05), as well as CCA in term/near-term CP (RR = 3.06, P < .01). The evidence for a causal or associative role of CA in CP is weak. Preterm HCA may be a risk factor for CP, whereas CCA is not. An association with term and preterm CP was found for CCA, but only with term CP for HCA.

Placing Maternal Obesity Among Pregnancy-Associated Risk Factors for Cerebral Palsy

Where does maternal body-mass index (BMI) fit among pregnancy-associated risk factors for cerebral palsy? To address this question, investigators

Risk of cerebral palsy in Chinese children: A N:M matched case control study.

To estimate epidemiological risk factors for cerebral palsy (CP) in children. A N:M matched case control study was conducted in 114 persons with CP and 1286 controls. Relevant data were collected using a maternal self-design questionnaire. Univariate logistic regression and multivariate conditional logistic regression analyses were performed using SPSS. Univariate analysis has yielded 20 significant risk factors for CP. Advanced maternal age (30 years or older) at childbirth (adjusted odds ratio (OR) 1.63, 95% confidence interval (CI) 0.98-2.72), alcohol consumption during pregnancy (adjusted OR 4.17, 95% CI 1.23-14.08), living in the countryside (adjusted OR 1.71, 95% CI 1.18-2.48), father's occupational exposure to harmful substances (adjusted OR 3.34, 95% CI 1.61-6.93) and multiple births (adjusted OR 3.10, 95% CI 1.65-5.84) were found to be risk factors for CP by multivariate analysis. On the other side, high mother's education level (adjusted OR 0.60, 95% CI 0.46-0.76), folic acid supplements (adjusted OR 0.50, 95% CI 0.30-0.82), and high birth hospital level (adjusted OR 0.68, 95% CI 0.52-0.90) were found to be protective factors. Although the important risk factors of CP focus on gestation at birth and perinatal events, the incidence could probably be further lowered, if potential risk factors identified in this study are considered.

An Evaluation of Risk Factors for Cerebral Palsy in Children in Jos, Nigeria

An Evaluation of Risk Factors for Cerebral Palsy in Children in Jos, Nigeria

Clinical Spectrum, Comorbidities, and Risk Factor Profile of Cerebral Palsy Children: A Prospective Study.

Aim and Objective:Cerebral palsy (CP) is the most common motor disability in childhood. This study aimed to describe clinical spectrum, comorbidities, and risk factors associated with CP children.Materials and Methods:This hospital-based observational study was conducted in tertiary level hospital in Jaipur including 180 CP children aged 1–12 years, attending the Paediatric Neurology Outdoor and Child Development Centre. A detailed history of antenatal, natal, and postnatal events taken and thorough examination was performed to stratify children in proper topographical and physiological classification.Results:Mothers of 47.7% CP children were primigravida and 17.7% mothers had anemia during pregnancy. Among natal factors, asphyxia contributed to maximum cases (52.2%). Seizure in postnatal life was the second most common risk factor for CP after asphyxia. Spastic CP (84.4%) was the most common physiological type, and quadriplegia (56.6%) was the most common topographical type observed in this study. Intellectual disability (47.7%) followed by epilepsy (41.6%) was the most common comorbidity.Conclusion:Even with the advancement of health-care system, asphyxia is the most common risk factor, and spastic quadriplegia is the most common type of CP. There is still a need of improving the health facilities to overcome this costly and common neuromotor disability. Widespread knowledge of common risk factors that can predispose to CP can prevent the CP development to some extent and knowledge of clinical spectrum, and comorbidities can improve their targeted treatment which can improve their growth and social participation.

SGA as a Risk Factor for Cerebral Palsy in Moderate to Late Preterm Infants: a System Review and Meta-analysis.

Small for gestational age (SGA) is an established risk factor for cerebral palsy (CP) in term infants. However, there is conflicting data on the association between SGA and CP in moderate to late preterm infants. The aim of the article was to explore the relationship between SGA and CP in the moderate to late preterm infants and its strength by meta-analysis. We performed a system search in OVID (EMBASE and MEDLINE) and WANFANG from inception to May 2016. The study-specific risk estimates were pooled using the random-effect model. A total of seven studies were included in the meta-analysis, consisting of three cohort and four case-control studies. A statistically significant association was found between SGA and CP in moderate to late premature infants (OR: 2.34; 95% CI: 1.43–3.82). The association were higher in the several subgroups: 34–36 week gestational age (OR: 3.47; 95% CI: 1.29–9.31), SGA < 2SDs (OR: 3.48; 95% CI: 1.86–6.49), and malformation included in CP (OR: 3.00; 95% CI: 1.71–5.26). In moderate to late premature infants, SGA is a convenient and reliable predictor for CP. More studies are needed to explore the underlying mechanisms between SGA and CP association.

Mode of delivery in breech presentation – a risk factor for cerebral palsy?

Mode of delivery in breech presentation – a risk factor for cerebral palsy?

Known risk factors and co-morbidities in 100 cases of cerebral palsy in a neu­rology follow-up clinic

Background: Cerebral palsy (CP) is a major cause of crippling in children. Several antenatal, natal and post natal factors for CP like birth asphyxia and pretenn &amp; LBW deliveries were identified.Objective: To see the presence of known risk factors of CP and co-morbidities in our setting. Methods: ln this study 100 cases of cerebral palsy attending the child neurology out-patient department Bangabandhu Sheikh Mujib Medical University (BSMMU) were evaluated with special attention to risk factors of CP. Full evaluation was done to find out co-morbidities. Results: Birth asphyxia (49%) was the most common risk factor. Mental retardation; speech problem and seizure were common co-morbidities. Conclusion: As birth asphyxia is common risk factor of cerebral palsy, it may be reduced by improving perinatal care.

滋賀県の脳性麻痺の疫学的検討-1977-2000- : 第2編 滋賀県の脳性麻痺の発生要因

滋賀県の脳性麻痺の疫学的検討-1977-2000- : 第2編 滋賀県の脳性麻痺の発生要因

Risk factors for cerebral palsy in PPROM and preterm delivery with intact membranes

Objective: Gestational age (GA) at delivery and spontaneous prematurity are independent risk factors for cerebral palsy (CP). The aim of this study is to investigate perinatal risk factors for CP in spontaneous preterm delivery.Methods: A retrospective cohort study of all single pregnancies complicated by spontaneous preterm labor (PTL) or PPROM with delivery at <34 weeks from January 2006 to December 2012 was performed. We compared demographic, obstetric, neonatal, and placental histology variables in cases of spontaneous preterm birth in reference to the development of CP. Statistical analysis included chi-square, one-way ANOVA and logistic regression analysis. p < 0.05 was considered significant.Results: Two hundred sixty-one women were included for this study. Of 249 survivors, 5 babies died during the first year of life, 52 did not fulfill the inclusion criteria for neurologic follow-up, and 24 were lost to follow up. Thus 168 infants in the study cohort underwent neurologic follow-up. We observed 26 cases of CP. Factors related to CP were lower GA at PROM (p = 0.007) and longer latency from PPROM to delivery (p = 0.002) in the PPROM group, lower GA at delivery (p < 0.001) and presence of funisitis (p <0.001) in the PTL group.Conclusions: GA at membrane rupture in PPROM and GA at delivery in PTL are significantly associated with CP. A process leading to neurological damage may be initiated at the moment of membranes rupture in cases of PPROM and at the time of PTL in the group with intact membranes.

A special supplement: findings from the Australian Cerebral Palsy Register, birth years 1993 to 2006.

To briefly outline the strengths and limitations of cerebral palsy (CP) registers, and to report on findings of the Australian Cerebral Palsy Register (ACPR) pertaining to a population cohort of children with CP. De-identified data were extracted from the ACPR for people with CP in birth years 1993 to 2006, from South Australia, Victoria, and Western Australia. Live birth prevalence of CP was estimated and risk factors described. The overall birth prevalence of CP (including those whose CP was postneonatally acquired) for the 1993 to 2006 birth cohort was 2.1 per 1000 live births (95% confidence interval [CI] 2.0-2.2). Excluding cases with a known postneonatal cause, the birth prevalence for pre/perinatally acquired CP was 2.0 per 1000 live births (95% CI 1.9-2.1). A downward trend in rates of CP in those born extremely preterm was evident over at least three consecutive periods across all three regions. Most (58.6%) children were born at term (≥ 37 wks). Male sex, early gestational age, low birthweight, and multiple birth were risk factors for CP. Overall rates of CP did not change during this period. The proportion of those with CP born extremely preterm decreased. The ACPR Group will investigate whether this pattern continues when data pertaining to the next birth cohort for all three regions becomes available.

Maternal Infections During Pregnancy and Cerebral Palsy in the Child

BackgroundChorioamnionitis is a risk factor for cerebral palsy. The relationship between extra-amniotic infections and cerebral palsy is less well studied. We examined maternal intra-amniotic and extra-amniotic infections and risk of cerebral palsy in the child. MethodsAmong a retrospective cohort of 6 million Californian births, 1991-2001, we analyzed administrative maternal and newborn hospital discharge abstracts linked to records of all children receiving services for cerebral palsy at the California Department of Developmental Services. We identified maternal hospital diagnoses of intra-amniotic (chorioamnionitis) and extra-amniotic (other genitourinary and respiratory) infections occurring up to 12 months before delivery. Using multivariable logistic regression, we determined the independent association between maternal infections and cerebral palsy, adjusting for infant sex, maternal age, race, education, socioeconomic status, and obesity. ResultsAbout 5.5% of mothers had a hospital discharge diagnosis of at least one of the following: chorioamnionitis (2.0%), other genitourinary (3.1%), and respiratory infection (0.6%). An infection diagnosis was more common in mothers of the 8473 infants with cerebral palsy than in mothers of unaffected children (13.7% vs 5.5%, P < 0.001). All three types of maternal infections (chorioamnionitis, odds ratio [OR] 3.1, 95% confidence interval [CI] 2.9-3.4; other genitourinary infection, OR 1.4, 95% CI 1.3-1.6; and respiratory infection, OR 1.9, 95% CI 1.5-2.2) were associated with cerebral palsy in multivariable analyses. Maternal extra-amniotic infections, whether diagnosed during prenatal or birth hospitalizations, conferred an increased risk of cerebral palsy. ConclusionsMaternal extra-amniotic infections diagnosed in the hospital during pregnancy are associated with a modestly increased risk of cerebral palsy in the child.

Evaluation of risk factors of cerebral palsy in a tertiary health facility, Nnewi, Nigeria: a case-control study

Background: Cerebral palsy is the most commonly diagnosed condition in children presenting with disability. This could be attributed to the lack of awareness on the quantifiable and largely preventable risk factors associated with it and poor knowledge of simple public health measures against these factors. Objective: To evaluate the risk factors associated with cerebral palsy in Nnamdi Azikwe University Teaching Hospital, Nnewi, Anambra state, Nigeria. Materials and Methods: This is a case–control study carried out with 40 case study population of children diagnosed with cerebral palsy and 80 control group of children who do not have cerebral palsy. The study was carried out using a pro forma to access and collect relevant data from the records (folders) of these individuals. Result: There is a statistically significant relationship between cerebral palsy and the following risk factors—birth asphyxia (X2 = 18.98; P < 0.01; OR = 7.71), neonatal jaundice (X2 = 5.958; P

Prevalence, Type, Maternal and Fetal risk factors analysis of cerebral palsy children in Hail region of Saudi Arabia

ABSTRACT Objectives: To identify the risk factors for cerebral palsy in hail region to help in designing preventive measures as a primary trial in management of cerebral palsy as it's a major cause of disability and to determine the clinical profile and major associated disabilities. Method: Screening all the medical files for children with cerebral palsy in the main rehabilitation center in hail region (Prince Salman center) to identify and analyze possible risk factors and to determine the clinical profile of children with cerebral palsy. Results: The most common risk factor found was low birth weight with percentage of 86.4% of children had birth weight of less than 2500g followed by mothers age more than 35years(80%) and then hypoxia(48%) Conclusion: Avoiding pregnancy with high mothers’ age and continued fetal monitoring can decrease risk of cerebral palsy.

Cerebral Palsy in 1-12 Year Old Children in Southern Iran.

Cerebral palsy (CP) is a non-progressive CNS disorder due to an insult to the growing brain, usually occurring in the first two years of life. During the recent years, its etiology has been changed; perinatal and postnatal insults are not considered as its main causes in developed countries any more. The aim of this study was to evaluate the causes of CP in children in southern Iran. Overall, 200 children with CP aged 1-12 yr old referring to Pediatric Neurology Clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran between 2012 and 2013 were enrolled. In addition, 200 healthy age and sex-matched children were considered as the control group. Exclusion criteria were isolated movement disorders with no other evidence of CP, progressive neurologic disorders, metabolic disorders, and incomplete or uncertain past history. After collecting the data on pregnancy period, prenatal history and past medical problems, they were analyzed with appropriate statistical methods. Maternal age, medical problems during pregnancy period, route of delivery, head circumference at birth, neonatal admission, neonatal jaundice, and prematurity were the main risk factors for CP. The distribution of risk factors of CP is different from that of developed countries in our region. Pre- and peri-natal etiologies are still among the common causes of CP in Iran.

Early onset preeclampsia and cerebral palsy: a double hit model?

Cerebral palsy (CP) is a late sequel of pregnancy, and the role of preeclampsia is debatable. The aims of this study were to determine the association between preeclampsia and cerebral palsy and to determine the risk factors for the development of cerebral palsy in these patients. A retrospective population-based cohort study was designed that included 229,192 singleton pregnancies. The study population was divided into 2 groups: (1) patients with preeclampsia (n = 9749) and (2) normotensive gestations (n = 219,443). Generalized Estimating Equation multiple logistic regression models were performed to study the associations among preeclampsia, small for gestational age, gestational age at delivery, and the risk factors for the development of cerebral palsy in neonates of women with preeclampsia. The rate of cerebral palsy was double in patients with preeclampsia than in the normotensive group (0.2% vs 0.1%; P = .015); early onset preeclampsia and small for gestational age were independent risk factors for the subsequent development of cerebral palsy (odds ratio, 8.639 [95% confidence interval, 4.269-17.480]; odds ratio, 2.737 [95% confidence interval, 1.937-3.868], respectively). A second model was conducted to determine the risk factors for the development of cerebral palsy in women with preeclampsia. Birth asphyxia, complications of prematurity, and neonatal infectious morbidity, but not small for gestational age or gestational age at delivery, were independent risk factors for the development of cerebral palsy. In a comparison with normal pregnant women, the rate of cerebral palsy is double among patients with preeclampsia, especially those with early-onset disease. Early-onset preeclampsia is an independent risk factor for cerebral palsy. Among women with preeclampsia, the presence of neonatal infectious morbidity, birth asphyxia, and complications of prematurity are independent risk factors for the development of cerebral palsy, which further supports the role of a multi-hit model in the pathogenesis of this syndrome.