1
|
Metz C, Jaster M, Walch E, Sarpong-Bengelsdorf A, Kaindl AM, Schneider J. Clinical Phenotype of Cerebral Palsy Depends on the Cause: Is It Really Cerebral Palsy? A Retrospective Study. J Child Neurol 2022; 37:112-118. [PMID: 34898314 PMCID: PMC8804944 DOI: 10.1177/08830738211059686] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cerebral palsy is the most common motor disability in childhood. Still, the precise definition in terms of causes and timing of the brain damage remains controversial. Several studies examine the clinical phenotype of cerebral palsy types. The aim of our study was to determine to what extent the clinical phenotype of cerebral palsy patients depends on the underlying cause. We retrospectively evaluated the clinical phenotype, abnormalities during pregnancy, and cerebral palsy cause of 384 patients, treated at Charité-Medicine University, between 2015 and 2017. The cause of cerebral palsy was identified in 79.9% of cases. Causes prior to the perinatal period were, compared to perinatal brain damage, associated significantly with different comorbidities. The term cerebral palsy does not describe a single disease but is an umbrella term covering many different diseases. Depending on the cause, a varying clinical phenotype can be found, which offers great potential in terms of individual treatment and preventing comorbidities.
Collapse
Affiliation(s)
- Charlotte Metz
- Charité-Universitätsmedizin
Berlin, Berlin, Germany,Charité-Universitätsmedizin
Berlin, Berlin, Germany,Joanna Schneider,
Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin.
| | - Monika Jaster
- Charité-Universitätsmedizin
Berlin, Berlin, Germany,Charité-Universitätsmedizin
Berlin, Berlin, Germany
| | - Elisabeth Walch
- Charité-Universitätsmedizin
Berlin, Berlin, Germany,Charité-Universitätsmedizin
Berlin, Berlin, Germany
| | | | - Angela M. Kaindl
- Charité-Universitätsmedizin
Berlin, Berlin, Germany,Charité-Universitätsmedizin
Berlin, Berlin, Germany,Berlin Institute of Health, Berlin, Germany,Charité-Universitätsmedizin
Berlin, Institute of Cell and Neurobiology, Berlin, Germany
| | - Joanna Schneider
- Charité-Universitätsmedizin
Berlin, Berlin, Germany,Charité-Universitätsmedizin
Berlin, Berlin, Germany,Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
2
|
Yamagishi H, Osaka H, Toyokawa S, Kobayashi Y, Shimoizumi H. Survey on children with cerebral palsy in Tochigi Prefecture, Japan. Pediatr Int 2021; 63:951-957. [PMID: 33176036 DOI: 10.1111/ped.14536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 10/20/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The incidence of cerebral palsy (CP) is influenced by perinatal medicine and regional medical systems. We investigated the recent incidence of CP and the current problems of children with CP in living at home under an advanced perinatal medical system in Tochigi Prefecture, Japan. METHODS A clinical datasheet survey was performed among 13 hospitals and six rehabilitation facilities treating children with CP born in Tochigi Prefecture to estimate the incidence of CP among children born between 2009 and 2013. The severity of motor and intellectual impairment, presumed causal factors, complications, and provided medical interventions were investigated and compared between preterm and term-born children with CP. RESULTS The incidence of CP was 1.6 per 1000 live births. Shorter gestation period and lower birthweight were associated with a higher incidence of CP. Fifty-one percent of children with CP were non-ambulatory and 55% had severe to profound intellectual impairment. Episodes of neonatal asphyxia and periventricular leukomalacia were the most frequent causal factors; both were significantly more frequent in preterm than in term-born children. Approximately 30% of children with CP had respiratory disorders, dysphagia, or epilepsy; 62% received medical interventions, including medication, mechanical ventilation, oxygen therapy, tube feeding, and intraoral/intranasal suction. CONCLUSION We found the incidence of CP to be lower in comparison to previous Japanese studies. However, the motor and intellectual impairments were severe, and many children with CP and their families were burdened by daily medical care. Public support systems should be developed, as well as the perinatal medical system.
Collapse
Affiliation(s)
- Hirokazu Yamagishi
- Department of Pediatrics, Jichi Medical University, Shimotsuke.,Department of Pediatrics, Nasu Institute for Developmental Disabilities, International University of Health and Welfare, Otawara
| | - Hitoshi Osaka
- Department of Pediatrics, Jichi Medical University, Shimotsuke
| | - Satoshi Toyokawa
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideo Shimoizumi
- Department of Pediatrics, Nasu Institute for Developmental Disabilities, International University of Health and Welfare, Otawara
| |
Collapse
|
3
|
Goldsmith S, Mcintyre S, Andersen GL, Gibson C, Himmelmann K, Blair E, Badawi N, Smithers-Sheedy H, Garne E. Congenital anomalies in children with pre- or perinatally acquired cerebral palsy: an international data linkage study. Dev Med Child Neurol 2021; 63:413-420. [PMID: 32578204 DOI: 10.1111/dmcn.14602] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/16/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023]
Abstract
AIM To describe the frequency and types of major congenital anomalies present in children with pre- or perinatally acquired cerebral palsy (CP), and compare clinical outcomes for children with and without anomalies. METHOD This multi-centre total population collaborative study between Surveillance of Cerebral Palsy in Europe, Australian Cerebral Palsy Register, and European Surveillance of Congenital Anomalies (EUROCAT) involved six European and three Australian regions. Data were linked between each region's CP and congenital anomaly register for children born between 1991 and 2009, and then pooled. Children were classified into mutually exclusive categories based on type of anomaly. Proportions of children with congenital anomalies were calculated, and clinical outcomes compared between children with and without anomalies. RESULTS Of 8201 children with CP, 22.8% (95% confidence interval [CI] 21.9, 23.8) had a major congenital anomaly. Isolated cerebral anomalies were most common (45.2%), with a further 8.6% having both cerebral and non-cerebral anomalies. Cardiac anomalies only were described in 10.5% of children and anomalies associated with syndromes were also reported: genetic (8.0%), chromosomal (5.7%), and teratogenic (3.0%). Clinical outcomes were more severe for children with CP and congenital anomalies, particularly cerebral anomalies. INTERPRETATION This large, international study reports major congenital anomalies in nearly one-quarter of children with pre- or perinatally acquired CP. Future research must focus on aetiological pathways to CP that include specific patterns of congenital anomalies. WHAT THIS PAPER ADDS Congenital anomalies were reported in 23% of children with pre- or perinatally acquired cerebral palsy. A higher proportion of children born at or near term had anomalies. The most common type of anomalies were isolated cerebral anomalies. Clinical outcomes were more severe for children with congenital anomalies (particularly cerebral).
Collapse
Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Guro L Andersen
- Cerebral Palsy Registry of Norway, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Catherine Gibson
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Kate Himmelmann
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Regional Rehabilitation Centre for Children and Adolescents, Queen Silvia's Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia.,Grace Centre for Newborn Intensive Care, Children's Hospital at Westmead, Sydney, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt Kolding, Kolding, Denmark
| | | |
Collapse
|
4
|
Al-Garni S, Derbala S, Saad H, Maaty AI. Developmental anomalies and associated impairments in Saudi children with cerebral palsy: a registry-based, multicenter study. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-021-00057-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There are few epidemiological data to support rehabilitation programs for cerebral palsy (CP). Scarce international studies described the developmental anomalies (DAs) among children with CP. To our knowledge, the Arab countries did not publish data regarding this topic. This study aimed to describe the percentage of DAs among children with CP and detect the association between clinical subtypes and impairment severity in children with various DAs. We collected registry data of 679 children with cerebral palsy, between 2014 and 2019, from Armed Forces Hospitals, Taif, Kingdom of Saudi Arabia (KSA). We recorded demographic, perinatal, postnatal, developmental anomalies, subtypes, and impairment characteristics. We utilized the chi-square test to calculate the differences between groups.
Results
We reported significant differences between the children with and without anomalies regarding the percentages of consanguinity, preterm labor, low birth weight, and neonatal intensive care unit admission (P = 0.001, 0.002, 0.003, 0.005, respectively). Congenital dysplasia of the hip and hydrocephalus was the most frequent skeletal and nervous anomalies among children with DAs (19.1% and 12.8%, respectively). The spastic bilateral pattern was significantly higher among children with skeletal anomalies than the central nervous system/other groups (P < 0.001). The nervous anomalies group had higher frequencies of severe intellectual, motor, speech, and visual disabilities and a higher percentage of seizures than all other groups.
Conclusions
The frequency of children with anomalies in this study was comparable to previous studies. Children with CP and nervous system anomalies had more severe motor disabilities and associated impairments.
Collapse
|
5
|
Martins PH, Duarte IPL, Leite CRVS, Cavalli RC, Marcolin AC, Duarte G. Influence of Religiosity on Situational Coping Scores in Women with Malformed Fetuses. JOURNAL OF RELIGION AND HEALTH 2020; 59:3071-3083. [PMID: 31664656 DOI: 10.1007/s10943-019-00934-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In clinical care settings, religiosity may serve as an important source of support for coping with the prenatal diagnosis of fetal abnormalities. This study evaluated the influence of religiosity on the situational coping of 28 pregnant women with fetal abnormalities. The study was approved by the institutional research ethics committee, and the informed consent document was obtained from all participants included in this study. Validated measures of religiosity and situational coping were used to evaluate data collected. Practical religiosity but not intrinsic religiosity correlated positively and significantly with coping scores. However, the severity of the fetal malformations did not correlate significantly with the scores of maternal coping. The results showed that religious practices were associated with improved coping in women diagnosed with fetal abnormalities and should be encouraged in care settings.
Collapse
Affiliation(s)
- Paulo Henrique Martins
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ilmara Pereira Leão Duarte
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Ricardo Carvalho Cavalli
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alessandra Cristina Marcolin
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Geraldo Duarte
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| |
Collapse
|
6
|
Jöud A, Sehlstedt A, Källén K, Westbom L, Rylander L. Associations between antenatal and perinatal risk factors and cerebral palsy: a Swedish cohort study. BMJ Open 2020; 10:e038453. [PMID: 32771990 PMCID: PMC7418660 DOI: 10.1136/bmjopen-2020-038453] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To investigate known and suggested risk factors associated with cerebral palsy in a Swedish birth cohort, stratified by gestational age. SETTING Information on all births between 1995 and 2014 in Skåne, the southernmost region in Sweden, was extracted from the national birth register. PARTICIPANTS The cohort comprised a total of 215 217 children. Information on confirmed cerebral palsy and subtype was collected from the national quality register for cerebral palsy (Cerebral Palsy Follow-up Surveillance Programme). PRIMARY AND SECONDARY OUTCOME MEASURES We calculated the prevalence of risk factors suggested to be associated with cerebral palsy and used logistic regression models to investigate the associations between potential risk factors and cerebral palsy. All analyses were stratified by gestational age; term (≥37 weeks), moderately or late preterm (32-36 weeks) and very preterm (<32 weeks). RESULTS In all, 381 (0.2 %) children were assigned a cerebral palsy diagnosis. Among term children, maternal preobesity/obesity, small for gestational age, malformations, induction, elective and emergency caesarian section, Apgar <7 at 5 min and admission to neonatal care were significantly associated with cerebral palsy (all p values<0.05). Among children born moderately or late preterm, small for gestational age, malformations, elective and emergency caesarian section and admission to neonatal care were all associated with cerebral palsy (all p values <0.05), whereas among children born very preterm no factors were significantly associated with the outcome (all p values>0.05). CONCLUSION Our results support and strengthen previous findings on factors associated with cerebral palsy. The complete lack of significant associations among children born very preterm probably depends on to the small number of children with cerebral palsy in this group.
Collapse
Affiliation(s)
- Anna Jöud
- Institution for Laboratory medicine, Division of Environmental and occupational medicine, Lund University, Lund, Sweden
| | - Andréa Sehlstedt
- Institution for Laboratory medicine, Division of Environmental and occupational medicine, Lund University, Lund, Sweden
| | - Karin Källén
- Clinical sciences Lund, Centre of reproductive epidemiology, Lunds Universitet, Lund, Sweden
| | - Lena Westbom
- Clinical Sciences Lund, Division of pediatrics, Lund University, Lund, Sweden
| | - Lars Rylander
- Institution for Laboratory medicine, Division of Environmental and occupational medicine, Lund University, Lund, Sweden
| |
Collapse
|
7
|
Sévère M, Ng P, Messerlian C, Andersen J, Buckley D, Fehlings D, Kirton A, Koclas L, Pigeon N, Van Rensburg E, Wood E, Shevell M, Oskoui M. Congenital Malformations in Children With Cerebral Palsy: Is Prematurity Protective? Pediatr Neurol 2020; 108:70-76. [PMID: 32386793 DOI: 10.1016/j.pediatrneurol.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 01/27/2020] [Accepted: 02/01/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Congenital malformations are more common in children who are born prematurely, and prematurity is the leading risk factor for cerebral palsy. The primary objective of this study was to describe the profile of congenital malformations in a Canadian cohort of children with cerebral palsy. The secondary objectives were to compare the profiles of children with cerebral palsy with and without a congenital malformation and explore the possible role of prematurity. METHODS This retrospective cohort study utilized data from the Canadian Cerebral Palsy Registry, a population based registry of children with a confirmed diagnosis of cerebral palsy. Differences between groups were compared using Pearson's chi-square and Student t test as appropriate. Odds ratios and 95% confidence intervals were calculated RESULTS: Congenital malformations were present in 23% participants. In term-born children, brain malformations were the most common, whereas heart and gastrointestinal malformations were more common in children born prematurely. Children with a malformation had higher odds of being born at term (odds ratio 1.57, 95% confidence interval 1.20 to 2.04); having hypotonic, ataxic, or dyskinetic cerebral palsy (odds ratio 1.92, 95% confidence interval 1.35 to 2.72; being nonambulatory (odds ratio 1.70, 95% confidence interval 1.29 to 2.25); and having cerebral palsy-associated comorbidities. CONCLUSIONS One in four children with cerebral palsy have an associated congenital malformation. Their profile of term birth, higher Apgar scores, and lower frequency of perinatal seizures suggests a distinct causal pathway.
Collapse
Affiliation(s)
- Marcel Sévère
- Department of Pediatrics, McGill University, Montreal, Quebec City, Canada
| | - Pamela Ng
- Child Health and Human Development, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Center, Montreal, Canada
| | - Carmen Messerlian
- Departments of Epidemiology and Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - John Andersen
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - David Buckley
- Department of Pediatrics, Janeway Children's Hospital, St. John's, Newfoundland and Labrador, Canada
| | - Darcy Fehlings
- Department of Paediatrics, University of Toronto, Bloorview Research Institute, Toronto, Ontario, Canada
| | - Adam Kirton
- Departments of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Louise Koclas
- Department of Pediatrics, Centre de réadaptation Marie Enfant du CHU Sainte-Justine
| | - Nicole Pigeon
- Department of Pediatrics, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec City, Canada
| | - Esias Van Rensburg
- Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Ellen Wood
- Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Michael Shevell
- Department of Pediatrics, McGill University, Montreal, Quebec City, Canada; Department of Neurology & Neurosurgery, McGill University, Montreal, Canada
| | - Maryam Oskoui
- Department of Pediatrics, McGill University, Montreal, Quebec City, Canada; Department of Neurology & Neurosurgery, McGill University, Montreal, Canada.
| |
Collapse
|
8
|
Manlongat E, Mcintyre S, Smithers-Sheedy H, Trivedi A, Muhit M, Badawi N, Khandaker G. Congenital anomalies in children with cerebral palsy in rural Bangladesh. Dev Med Child Neurol 2020; 62:463-469. [PMID: 31903557 DOI: 10.1111/dmcn.14456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2019] [Indexed: 12/21/2022]
Abstract
AIM To determine the proportion of children with cerebral palsy (CP) who had major congenital anomalies, describe the types of disorders, and report on the children's functional outcomes. METHOD Data were extracted from the Bangladesh Cerebral Palsy Register (BCPR). Descriptive analyses were conducted on children with CP and major congenital anomalies. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to measure the association between major congenital anomalies, clinical severity, and presence of comorbidities. RESULTS Between January 2015 and December 2016, 726 children with CP were newly registered with the BCPR (277 females, 449 males; mean age [SD] at registration 90mo [54mo], 4mo-18y). Seventy-eight children (11%) had a major congenital anomaly. Neurological (86%) and musculoskeletal congenital anomalies (10%) were the most common. Microcephaly was the most common congenital anomaly (83%). The odds of severe functional motor limitations (OR=2.4, 95% CI=1.9-2.9), epilepsy (OR=1.6, 95% CI=1.1-2.1), visual impairment (OR=2.6, 95% CI=2.0-3.2), presence of strabismus (OR=3.9, 95% CI=3.8-4.4), hearing (OR=1.2, 95% CI=0.6-1.9), speech (OR=5.4, 95% CI=4.6-6.2), and intellectual impairments (OR=2.3, 95% CI=1.8-2.8) were higher in children with congenital anomalies compared to children without. INTERPRETATION The proportion of children with major congenital anomalies in the BCPR (11%) was lower than that identified in higher-income countries. This may be because of differences in how congenital anomalies are diagnosed as well as the impact of survival bias. In Bangladesh, children with CP and major congenital anomalies are more likely to have severe functional motor limitations and associated comorbidities. WHAT THIS PAPER ADDS Eleven per cent of children with cerebral palsy (CP) in Bangladesh had major congenital anomalies. Neurological and musculoskeletal congenital anomalies were the most common. Severe functional motor limitations and associated comorbidities were more common in children presenting with CP and major congenital anomalies.
Collapse
Affiliation(s)
- Ellen Manlongat
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Camperdown, NSW, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Camperdown, NSW, Australia.,The University of Sydney Children's Hospital Westmead Clinical School, Sydney, NSW, Australia
| | - Amit Trivedi
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Westmead, NSW, Australia.,The University of Sydney Children's Hospital Westmead Clinical School, Sydney, NSW, Australia
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
| | - Nadia Badawi
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Camperdown, NSW, Australia.,The University of Sydney Children's Hospital Westmead Clinical School, Sydney, NSW, Australia
| | - Gulam Khandaker
- The University of Sydney Children's Hospital Westmead Clinical School, Sydney, NSW, Australia.,CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.,Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD, Australia
| |
Collapse
|
9
|
Abstract
BACKGROUND Cerebral palsy (CP) is a non-progressive, everlasting neurological disorder of movement, posture, and physical activities, with a prevalence of 2.2-3.3/1,000. CP is a condition that occurs globally, with a similar prevalence in both developed and undeveloped countries. However, the etiology differs according to the socioeconomic status of the countries. The objective is to determine the pattern and the contributing factors of CP among Sudanese children. METHODS This was a retrospective hospital-based study conducted over a period of three years in a pediatric referral hospital in Khartoum, Sudan. One hundred and eight patients of CP were enrolled, of whom 59 (54.6%) were males and 49 (45.4%) were females. RESULTS Spastic quadriplegic CP was the most common type. Most cases were from lower social classes. Prenatal, antenatal, and unclassified CP were found in 45 (41.7%), 31 (28.7.%), 23 (21.3%), and 9 (8.3%) cases, respectively. Birth asphyxia, neonatal jaundice, Toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus infections (TORCH), and sepsis (acquired) were the main causative factors. CONCLUSION Spastic quadriplegia is the most common type of CP. Most of the cases had a direct positive relationship with socioeconomic status. The prenatal period was the most common period for the development of CP.
Collapse
Affiliation(s)
- Karimeldin Salih
- Pediatrics, College of Medicine, University of Bisha, Bisha, SAU
| |
Collapse
|
10
|
Goldsmith S, McIntyre S, Hansen M, Badawi N. Congenital Anomalies in Children With Cerebral Palsy: A Systematic Review. J Child Neurol 2019; 34:720-727. [PMID: 31208251 DOI: 10.1177/0883073819854595] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Congenital anomalies are a strong risk factor for cerebral palsy, particularly for children born at term. This systematic review aimed to address gaps in our understanding of the association between congenital anomalies and cerebral palsy. Eight population-based studies (n = 10 081) were identified. Congenital anomalies were reported in 12% to 32% of children with pre/perinatal brain injury and 20% of children with postneonatal brain injury. Variation between studies included study cohort inclusion criteria and the definitions and classification of included anomalies. The most common cerebral anomalies were microcephaly and hydrocephaly, whereas circulatory system anomalies were the most common noncerebral anomalies. The proportion of congenital anomalies was higher in children born at term than preterm. Synthesizing the highest quality data published, this review identified that congenital anomalies are common in cerebral palsy. New collaborative research, addressing sources of variation, is vital to identify pathways to cerebral palsy that include specific congenital anomalies, and explore opportunities for prevention.
Collapse
Affiliation(s)
- Shona Goldsmith
- 1 Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sarah McIntyre
- 1 Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Michele Hansen
- 2 Telethon Kids Institute, University of Western Australia, West Perth, Western Australia, Australia
| | - Nadia Badawi
- 1 Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
11
|
Woolfenden S, Galea C, Smithers-Sheedy H, Blair E, Mcintyre S, Reid S, Delacy M, Badawi N. Impact of social disadvantage on cerebral palsy severity. Dev Med Child Neurol 2019; 61:586-592. [PMID: 30221759 DOI: 10.1111/dmcn.14026] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2018] [Indexed: 12/27/2022]
Abstract
AIM To investigate the impact of socio-economic disadvantage on indicators of cerebral palsy (CP) severity - motor impairment, intellectual disability, and the presence of severe comorbidities - in children with CP in Australia. METHOD Data from the Australian Cerebral Palsy Register were analysed. Socio-economic disadvantage was assessed using maternal age, maternal country of birth, and a measure of neighbourhood socio-economic status (SES) at the time of the child's birth. Descriptive bivariate analysis, trend analysis, risk ratios, and mediation analysis were undertaken to examine the impact of disadvantage on the indicators of CP severity. RESULTS A socio-economic gradient was demonstrated with an increasing proportion of children with non-ambulant status, at least moderate intellectual disability, and the presence of severe comorbidities (having epilepsy, functional blindness, bilateral deafness, and/or no verbal communication) with decreasing neighbourhood SES, adolescent motherhood, and maternal minority ethnicity. INTERPRETATION In Australia, socio-economic disadvantage at birth impacts adversely on CP severity at age 5 years. By identifying that socio-economically disadvantaged children with CP are at greater risk of more severe functional outcomes, we can inform targeted interventions at the family and neighbourhood level to reduce these inequities for children with CP. WHAT THIS PAPER ADDS Socio-economic disadvantage is associated with increased severity of cerebral palsy functional outcomes. This encompasses low neighbourhood socio-economic status, adolescent motherhood, and maternal minority ethnicity.
Collapse
Affiliation(s)
- Sue Woolfenden
- Department of Community Child Health, Sydney Children's Hospitals Network, Sydney, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Claire Galea
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Sue Reid
- Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Michael Delacy
- Queensland Cerebral Palsy Register, CPL - Choice, Passion, Life, Brisbane, QLD, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,The Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | | | | |
Collapse
|
12
|
Gincota Bufteac E, Andersen GL, Torstein V, Jahnsen R. Cerebral palsy in Moldova: subtypes, severity and associated impairments. BMC Pediatr 2018; 18:332. [PMID: 30340478 PMCID: PMC6195696 DOI: 10.1186/s12887-018-1305-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 10/08/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND 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. 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. METHODS Children 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. RESULTS Among 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. CONCLUSION Compared 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.
Collapse
Affiliation(s)
- Ecaterina Gincota Bufteac
- Department of Health Sciences, Oslo Metropolitan University, PO box 4 St. Olavs plass, No-0130 Oslo, Norway
- Early Intervention Center ‘Voinicel’, Drumul Taberei str., nr.2A, Chisinau, Moldova
| | - Guro L. Andersen
- The Cerebral Palsy Register of Norway (CPRN), Department of Paediatrics, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, PO Box 8905, 7491 Trondheim, Norway
| | - Vik Torstein
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, PO Box 8905, 7491 Trondheim, Norway
| | - Reidun Jahnsen
- The Cerebral Palsy Follow-up Program (CPOP), Department of Clinical Neurosciences for Children, Oslo University Hospital, Box 4950, Nydalen, 0424 Oslo, Norway
| |
Collapse
|
13
|
Decreasing prevalence and severity of cerebral palsy in Norway among children born 1999 to 2010 concomitant with improvements in perinatal health. Eur J Paediatr Neurol 2018; 22:814-821. [PMID: 29779984 DOI: 10.1016/j.ejpn.2018.05.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/16/2018] [Accepted: 05/01/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND The aim of our study was to explore if the prevalence and clinical characteristics of cerebral palsy (CP), concomitant with perinatal health indicators in the general population, remained unchanged for children born in Norway between 1999 and 2010. METHODS This national multi-register cohort study included 711 174 children recorded in the Medical Birth Registry of Norway. Among these, 707 916 were born alive, and 1664 had a validated diagnosis of CP recorded in the Cerebral Palsy Registry of Norway and/or the Norwegian Patient Registry. Prevalence per 1000 live births as a function of birth year was analyzed using logistic regression with fractional polynomials to allow for non-linear trends. Chi-square statistics were used to estimate trends in proportions of clinical characteristics. RESULTS The prevalence of CP in Norway decreased from 2.62 per 1000 live births in 1999 to 1.89 in 2010. The reduction was most evident among children with bilateral CP, in particular those with diplegia. During the study period, the proportions of children with severe motor impairments, epilepsy, intellectual impairment and reduced speech also decreased. At the same time, perinatal mortality has decreased in Norway, along with the proportion of women with preeclampsia, children born preterm or as a multiple. CONCLUSION We observed a significant decrease in the prevalence and severity of CP subtypes and associated impairments among children with CP in Norway. This coincided with improvements in perinatal health indicators in the general population. These improvements are most likely explained by advancements in obstetric and neonatal care.
Collapse
|
14
|
Affiliation(s)
- Jane Williams
- Department of Neurosciences, Family Health, Nottingham University Hospitals NHS Trust, Nottingham, UK
| |
Collapse
|