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The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery 1/2021

Open Access 01-12-2021 | Research

Evaluation of risk factors for cerebral palsy

Authors: Dina Salama Abd Elmagid, Hend Magdy

Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Issue 1/2021

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Abstract

Background

Cerebral palsy (CP) has been identified as one of the most important and common causes of childhood disabilities worldwide and is often accompanied by multiple comorbidities. CP is defined as a group of disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The objective of our study was to describe main clinical pattern and motor impairments of our patients, and to evaluate the presence of risk factors and if there is a relation to the type of cerebral palsy.

Methods

Children with cerebral palsy were retrospectively enrolled over 2 years from the neurology outpatient clinics. Cerebral palsy risk factors and motor impairments were determined through caregiver interviews, review of medical records, and direct physical examination.

Results

One thousand children with cerebral palsy were enrolled. Subjects were 64.4% male, with a median age of 2.5 years. The risk factors for cerebral palsy in our study were antenatal (21%), natal and post-natal (30.5%), post-neonatal (17.1%), and unidentified (31.4%). Antenatal as CNS malformation (26.6%), maternal DM (17.6%), prolonged rupture of membrane (11.9%), maternal hemorrhage (10.4%), and pre-eclampsia (4.7%). Natal and post-natal as hypoxic ischemic encephalopathy (28.5%), infection (16.3%), hyperbilirubinemia (12.7%), cerebrovascular accidents (8.8%), meconium aspiration (6.2%), and intracranial hemorrhage. Post-neonatal as CNS infection (34.5%), cerebrovascular accidents (28.6%), sepsis (23.9%), and intracranial hemorrhage (8.7%).

Conclusions

Cerebral palsy has different etiologies and risk factors. Further studies are necessary to determine optimal preventative strategies in these patients.
Literature
1.
Paneth N, Hong T, Korzeniewski S. The descriptive epidemiology of cerebral palsy. Clin Perinatol. 2006;33:251–67.PubMedCrossRef
2.
Robertson CMT, Ricci MF, O'Grady K, Oskoui M, Goez H, Yager JY, et al. Prevalence estimate of cerebral palsy in Northern Alberta: Births, 2008–2010. Can J Neurol Sci. 2017;44:366–74.PubMedCrossRef
3.
Kakooza-Mwesige A, Andrews C, Peterson S, Mangen FW, Eliasson AC, Forssberg H. Prevalence of cerebral palsy in Uganda: a population-based study. Lancet Glob Health. 2017;5:1275–82.CrossRef
4.
EI-Tallawy HN, Farghaly WM, Shehata GA, Rageh TA, Metwally NA, Badry R, et al. Cerebral palsy in AI-Quseir City, Egypt: prevalence, subtypes, and risk factors. Neuropsychiatr Dis Treat. 2014;10:1267–72.
5.
Rosenbaum P. A report: the definition and classification of cerebral palsy. Dev Med Child Neurol. 2007;49(6):480.
6.
7.
Cans C. Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE) Dev. Med. Child Neurol. 2000;42:816–24.
8.
Oskoui M, Coutinho F, Dykeman J, Jette N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2013;55:509–19.PubMedCrossRef
9.
Gorter JW, Ketelaar M, Rosenbaum P, Helders PJ, Palisano R. Use of the GMFCS in infants with CP: the need for reclassification at age 2 years or older. Dev Med Child Neurol. 2009;51:46–52.PubMedCrossRef
10.
Boychuck Z, Bussieres A, Goldschleger J, Majnemer A. Age at referral for diagnosis and rehabilitation services for cerebral palsy: a scoping review. Dev Med Child Neurol. 2019;61:908–14.PubMedCrossRef
11.
Ostensjo S, Carlberg EB, Vollestad NK. Motor impairments in young children with cerebral palsy: relationship to gross motor function and everyday activities. Dev Med Child Neurol. 2004;46(9):580–9.PubMedCrossRef
12.
13.
Shevell MI. Dagenais L and Hall N REPACQ Consortium. Comorbidities in cerebral palsy and their relationship to neurologic subtype and GMFCS level. Neurology. 2009;72:2090–6.PubMedCrossRef
14.
Cans C. Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol. 2000;42:816–24.CrossRef
15.
MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: causes, pathways, and the role of genetic variants. Am J Obstet Gynecol. 2015;213:779–88.PubMedCrossRef
16.
17.
18.
Moster D, Lie RT, Markestad T. Long-term medical and social consequences of preterm birth. N Engl J Med. 2008;359:262–73.PubMedCrossRef
19.
McIntyre S, Taitz D, Keogh J, Goldsmith S, Badawi N, Blair E. A systematic review of risk factors for cerebral palsy in children born at term in developed countries. Dev Med Child Neurol. 2013;55:499–508.PubMedCrossRef
20.
Blair E, Love S. Commentary on definition and classification of cerebral palsy. Dev Med Child Neurol. 2005;47:510–6.CrossRef
21.
Bax M, Goldstein M, Rosenbaum P, et al. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol. 2005;47:571–6.PubMedCrossRef
22.
Himmelmann K, Hagberg G, Beckung E, Hagberg B, Uvebrant P. The changing panorama of cerebral palsy in Sweden. IX. Prevalence and origin in the birth-year period 1995-1998. Acta Paediatr. 2005;94:287–94.PubMedCrossRef
23.
Mathews TJ, Menacker F, MacDorman MF. Infant mortality statistics from the 2002 period: linked birth/infant death data set. Natl Vital Stat Rep. 2004;53:1–29.PubMed
24.
ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. Int J Gynecol Obstet. 2002;77(1):67–75.
25.
Croen LA, Grether JK, Curry CJ, Nelson KB. Congenital abnormalities among children with cerebral palsy: More evidence for prenatal antecedents. J Pediatr. 2001;138(6):804–10.PubMedCrossRef
26.
Stanley F, Blair E, Alberman E. Postneonatally acquired cerebral palsy: incidence and antecedants. In: Bax MCO, Hart HM, editors. Cerebral Palsies: Epidemiology and Causal Pathways. London: Mc Keith Press; 2000. p. 124–37.
27.
Giraudon I, Forde J, Maguire H, Arnold J, Permalloo N. Antenatal screening and prevalence of infection: surveillance in London, 2000-2007. Euro Surveill. 2009;514(9):8–12.
28.
ACOG technical bulletin, et al. Int J Gynaecol Obstet. 1996;53(2):175–83.CrossRef
29.
ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 188: Prelabor Rupture of Membranes. Obstet Gynecol. 2018;131(1):1–14.
30.
Uvebrant P. Hemiplegic cerebral palsy. Etiology and outcome. Acta Paediatr Scand Suppl. 1988;345:1–100.PubMedCrossRef
31.
Krägeloh-Mann I, Petersen D, Hagberg G, Vollmer B, Hagberg B, Michaelis R. Bilateral spastic cerebral palsy – MRI pathology and origin. Analysis from a representative series of 56 cases. Dev Med Child Neurol. 1995;37:379–97.PubMedCrossRef
32.
Thorngren-Jerneck K, Herbst A. Perinatal factors associated with cerebral palsy in children born in Sweden. Obstet Gynecol. 2006;108(6):1499–505.PubMedCrossRef
33.
Smith J, Wells L, Dodd K. The continuing fall in incidence of hypoxic-ischaemic encephalopathy in term infants. Br J Obstet Gynaecol. 2000;107(4):461–6.CrossRef
34.
Glezerman M. For debate: is gender medicine important in pediatrics? Pediatr Endocrinol Rev. 2009;6(4):454–6.PubMed
35.
Mutch L, Alberman E, Hagberg B, Kodama K, Perat MV. Cerebral palsy epidemiology: where are we now and where are we going? Dev Med Child Neurol. 1992;34:547–51.PubMedCrossRef
36.
Walstab J, Bell R, Reddihough D, Brennecke S, Bessell C, Beischer N. Antenatal and intrapartum antecedents of cerebral palsy: a case-control study. Aust N Z J Obstet Gynaecol. 2002;42(2):138–46.PubMedCrossRef
37.
Wu YW, Croen LA, Shah SJ, Newman TB, Daniel V. Cerebral palsy in a term population: risk factors and neuroimaging findings. Pediatrics. 2006;118:690.PubMedCrossRef
38.
Topp M, Huusom LD, Langhoff-Roos J, Delhumeau C, Hutton JL, Dolk H. Multiple birth and cerebral palsy in Europe: a multicenter study. Acta Obstet Gynecol Scand. 2004 Jun;83(6):548–53.PubMedCrossRef
39.
Pharoah PO, Dundar Y. Monozygotic twinning, cerebral palsy and congenital anomalies. Hum Reprod Update. 2009;15(6):639–48.PubMedCrossRef
40.
Fuster V, Zuluaga P, Colantonio S, de Blas C. Factors associated with recent increase of multiple births in Spain. Twin Res Hum Genet. 2008;11:70–6.PubMedCrossRef
41.
Spinillo A, Capuzzo E, Orcesi S, Stronati M, Di Mario M, Fazzi E. Antenatal and delivery risk factors simultaneously associated with neonatal death and cerebral palsy in preterm infants. Early Hum Dev. 1997;48:81–91.PubMedCrossRef
42.
O’Shea TM, Klinepeter KL, Dillard RG. Prenatal events and the risk of cerebral palsy in very low birth weight infants. Am J Epidemiol. 1998;147:362–9.PubMedCrossRef
43.
O’Shea TM, Klinepeter KL, Meis PJ, Dillard RG. Intrauterine infection and the risk of cerebral palsy in very low-birth weight infants. Paediatr Perinat Epidemiol. 1998;12:72–83.PubMedCrossRef
44.
Grether JK, Nelson KB, Emery ES, Cummins SK. Prenatal and perinatal factors and cerebral palsy in very low birth weight infants. J Pediatr. 1996;128:407–14.PubMedCrossRef
45.
Garne E, Dolk H, Krägeloh-Mann I, Holst Ravn S, Cans C. Cerebral palsy and congenital malformations. Eur J Paediatr Neurol. 2008;12(2):82–8.PubMedCrossRef
46.
Self L, Dagenais L, Shevell M. Congenital non-central nervous system malformations in cerebral palsy: a distinct subset? Dev Med Child Neurol. 2012;54(8):748–52.PubMedCrossRef
47.
Jacobsson B, Hagberg G, Hagberg B, Ladfors L, Niklasson A, Hagberg H. Cerebral palsy in preterm infants: a population-based case-control study of antenatal and intrapartum risk factors. Acta Paediatr. 2002;91:946–51.PubMedCrossRef
48.
49.
Ahanya SN, Lakshmanan J, Morgan BL, Ross MG. Meconium passage in utero: mechanisms, consequences, and management. Obstet Gynecol Surv. 2005;60:45–56.PubMedCrossRef
50.
Jain PG, Sharma R, Bhargava M. Perinatal outcome of meconium stained liquor in pre-term, term and post-term pregnancy. Indian J Obstet Gynecol Res. 2017;4(2):146–50.
51.
Badawi N, Felix JF, Kurinczuk JJ, Dixon G, Watson L, Keogh JM, et al. Cerebral palsy following term newborn encephalopathy: a population-based study. Dev Med Child Neurol. 2005;47:293–8.PubMedCrossRef
52.
Pschirrer R, Yeomans E. Does asphyxia cause cerebral palsy? Semin Perinatol. 2000;24:215.220.CrossRef
53.
Glass HC, Bonifacio SL, Chau V, Glidden D, Poskitt K, Barkovich AJ, et al. Recurrent postnatal infections are associated with progressive white matter injury in premature infants. Pediatrics. 2008;122:299–305.PubMedCrossRef
54.
Roze E, Benders MJ, Kersbergen KJ, van der Aa NE, Groenendaal F, van Haastert IC, et al. Neonatal DTI early after birth predicts motor outcome in preterm infants with periventricular hemorrhagic infarction. Pediatr Res. 2015;78(3):298–303.PubMedCrossRef
55.
56.
Cans C, McManus V, Crowley M, Guillem P, Platt MJ, Johnson A, et al. Cerebral palsy of post-neonatal origin: characteristics and risk factors. Paediatr Perinat Epidemiol. 2004 May;18(3):214–20.PubMedCrossRef
57.
Reid SM, Dagia CD, Ditchfield MR, Carlin JB, Reddihough DS. Population-based studies of brain imaging patterns in cerebral palsy. Dev Med Child Neurol. 2014;56:222–32.PubMedCrossRef
58.
Himpens E, Van Den Broeck C, Oostra A, Calders P, Vanhaesebrouck P. Prevalence, type, distribution, and severity of cerebral palsy in relation to gestational age: a meta-analytic review. Dev Med Child Neurol. 2008;50:334–40.PubMedCrossRef
59.
Marlow N, Wolke D, Bracewell MA, Samara M. Neurologic and developmental disability at six years of age after extremely preterm birth. N Enlg J Med. 2005;352(1):9–19.CrossRef
60.
Surveillance of Cerebral Palsy in Europe (SCPE). Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol. 2000;42(12):816–24.CrossRef
61.
Reid SM, Meehan E, McIntyre S, Goldsmith S, Badawi N, Reddihough DS. Temporal trends in cerebral palsy by impairment severity and birth gestation. Dev Med Child Neurol. 2016;58(2):25–35.PubMedCrossRef
62.
Michael G, Bainbridge MN, Haan E, Corbett M, Gardner A, Thompson S, et al. Whole-exome sequencing points to considerable genetic heterogeneity of cerebral palsy. Mol Psychiatry. 2015;20(2):176–82.CrossRef
Metadata
Title
Evaluation of risk factors for cerebral palsy
Authors
Dina Salama Abd Elmagid
Hend Magdy
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
DOI
https://doi.org/10.1186/s41983-020-00265-1

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