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Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy

Background: Cerebral palsy (CP) is not a defined, separate disease classification, but a set of etiologically diverse symptoms that change with the child’s age. According to the up-to-date definition, CP is a group of permanent but not unchanging disorders of movement and/or posture and motor functi...

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Autores principales: Sadowska, Małgorzata, Sarecka-Hujar, Beata, Kopyta, Ilona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615573/
https://www.ncbi.nlm.nih.gov/pubmed/34827447
http://dx.doi.org/10.3390/brainsci11111448
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author Sadowska, Małgorzata
Sarecka-Hujar, Beata
Kopyta, Ilona
author_facet Sadowska, Małgorzata
Sarecka-Hujar, Beata
Kopyta, Ilona
author_sort Sadowska, Małgorzata
collection PubMed
description Background: Cerebral palsy (CP) is not a defined, separate disease classification, but a set of etiologically diverse symptoms that change with the child’s age. According to the up-to-date definition, CP is a group of permanent but not unchanging disorders of movement and/or posture and motor function, which are due to a nonprogressive interference, lesion, or abnormality of the developing/immature brain. CP is one of the most frequent causes of motor disability in children. The aim of the present study was to analyze whether selected risk factors may vary depending on particular types of CP. Methods: 181 children with CP (aged 4–17 years), hospitalized at the Department of Pediatrics and Developmental Age Neurology in Katowice in the years 2008–2016 were retrospectively analyzed in the present study. The assumed risk factors of CP were divided into two groups: 1—pre-conception and prenatal (mother’s age, family history of epilepsy, burdened obstetric history, mother’s systemic diseases, pregnancy order, multiple pregnancy, duration of pregnancy, bleedings from the genital tract during gestation, arterial hypertension during pregnancy, infections during pregnancy, preterm contractions, maintained pregnancy, premature rupture of membranes, abruptio placentae, and others), 2—perinatal and postnatal (mode of delivery, birth weight, Apgar score at the first and fifth minute, neonatal convulsions, respiratory failure, infections in neonatal and infant period, and intraventricular bleeding). The division into particular CP types was based on Ingram’s classification. Results: The following risk factors were the most frequent in the total group: respiratory failure, infections, intraventricular bleeding, and prematurity. Among the analyzed preconception and prenatal factors, the duration of pregnancy and preterm contractions during pregnancy significantly differentiated the subgroups of patients depending on the type of CP. The prevalence of almost all analyzed perinatal, neonatal, and infant-related risk factors (i.e., birth weight, Apgar score at the first and fifth minute, neonatal convulsions, respiratory failure, infections in neonatal and infant period, and intraventricular bleeding) significantly differed between CP types, apart from the mode of delivery. However, in multivariate regression, only intraventricular bleeding was an independent predictor for tetraplegic CP type when compared to joined extrapyramidal and ataxic types (OR = 2.801, p = 0.028). Conclusions: As CP is a syndrome of multifactorial etiology, the identification of CP risk factors entails the need for careful observation and comprehensive care of children in the risk group. The presence of certain risk factors may be a prognostic indicator for particular types of CP. The knowledge about the association between the risk factor(s) and the CP type could be a very useful tool for pediatricians looking after the child at risk of developmental disorders.
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spelling pubmed-86155732021-11-26 Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy Sadowska, Małgorzata Sarecka-Hujar, Beata Kopyta, Ilona Brain Sci Article Background: Cerebral palsy (CP) is not a defined, separate disease classification, but a set of etiologically diverse symptoms that change with the child’s age. According to the up-to-date definition, CP is a group of permanent but not unchanging disorders of movement and/or posture and motor function, which are due to a nonprogressive interference, lesion, or abnormality of the developing/immature brain. CP is one of the most frequent causes of motor disability in children. The aim of the present study was to analyze whether selected risk factors may vary depending on particular types of CP. Methods: 181 children with CP (aged 4–17 years), hospitalized at the Department of Pediatrics and Developmental Age Neurology in Katowice in the years 2008–2016 were retrospectively analyzed in the present study. The assumed risk factors of CP were divided into two groups: 1—pre-conception and prenatal (mother’s age, family history of epilepsy, burdened obstetric history, mother’s systemic diseases, pregnancy order, multiple pregnancy, duration of pregnancy, bleedings from the genital tract during gestation, arterial hypertension during pregnancy, infections during pregnancy, preterm contractions, maintained pregnancy, premature rupture of membranes, abruptio placentae, and others), 2—perinatal and postnatal (mode of delivery, birth weight, Apgar score at the first and fifth minute, neonatal convulsions, respiratory failure, infections in neonatal and infant period, and intraventricular bleeding). The division into particular CP types was based on Ingram’s classification. Results: The following risk factors were the most frequent in the total group: respiratory failure, infections, intraventricular bleeding, and prematurity. Among the analyzed preconception and prenatal factors, the duration of pregnancy and preterm contractions during pregnancy significantly differentiated the subgroups of patients depending on the type of CP. The prevalence of almost all analyzed perinatal, neonatal, and infant-related risk factors (i.e., birth weight, Apgar score at the first and fifth minute, neonatal convulsions, respiratory failure, infections in neonatal and infant period, and intraventricular bleeding) significantly differed between CP types, apart from the mode of delivery. However, in multivariate regression, only intraventricular bleeding was an independent predictor for tetraplegic CP type when compared to joined extrapyramidal and ataxic types (OR = 2.801, p = 0.028). Conclusions: As CP is a syndrome of multifactorial etiology, the identification of CP risk factors entails the need for careful observation and comprehensive care of children in the risk group. The presence of certain risk factors may be a prognostic indicator for particular types of CP. The knowledge about the association between the risk factor(s) and the CP type could be a very useful tool for pediatricians looking after the child at risk of developmental disorders. MDPI 2021-10-30 /pmc/articles/PMC8615573/ /pubmed/34827447 http://dx.doi.org/10.3390/brainsci11111448 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sadowska, Małgorzata
Sarecka-Hujar, Beata
Kopyta, Ilona
Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy
title Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy
title_full Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy
title_fullStr Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy
title_full_unstemmed Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy
title_short Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy
title_sort analysis of selected risk factors depending on the type of cerebral palsy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615573/
https://www.ncbi.nlm.nih.gov/pubmed/34827447
http://dx.doi.org/10.3390/brainsci11111448
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