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

2021 ◽  
Vol 11 (11) ◽  
pp. 1448
Author(s):  
Małgorzata Sadowska ◽  
Beata Sarecka-Hujar ◽  
Ilona Kopyta

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.

Author(s):  
Rita Saxena ◽  
Brinda Patel ◽  
Anjana Verma

Background: Oligohydramnios is one of the major causes of perinatal morbidity and mortality. The sonographic diagnosis of oligohydramnios is usually based on an AFI≤5 cm or on a single deepest pocket of amniotic fluid≤2 cm3. Our study was aimed to study the perinatal outcome in oligohydramnios. Aim and objective were to study obstetric risk factors associated with oligohydramnios and maternal outcome in the form of mode of delivery, and to assess neonatal complications in terms of APGAR score at birth, NICU admission rates, meconium stained liquor and still birth rates.Methods: It was an Observational, Prospective, clinical study of 100 pregnant patients diagnosed with oligohydramnios by ultrasound, carried out in Geetanjali medical college and hospital, Udaipur for period of from January 2020-August 2020. The study was conducted after ethical clearance and with informed consent. Detailed history on demographic profile, medical illness, obstetric history and antenatal complication if any in the present pregnancy; general examination, obstetric examination and bimanual examination were performed meticulously.Results: In our study 53% cases of oligohydramnios were associated with some of the risk factors like PIH (29%), IUGR (22%), fetal anomaly (1%), systemic maternal disease (1%) and 47% of the cases were Idiopathic. LSCS was done in 85.71% cases with AFI<5 cm. Low birth weight was found in 51.43% cases with AFI<5 cm. NICU admission was required for 28.57% cases with AFI<5 cm.Conclusions: AFI is an important and convenient screening test for prediction of perinatal outcome. In presence of oligohydramnios, the risk of fetal distress, operative delivery, low Apgar score, low birth weight, perinatal morbidity and mortality are more. Hence early detection of oligohydramnios, associated antenatal risk factors and timely management can improve the maternal and fetal outcome.


2012 ◽  
Vol 15 (1) ◽  
pp. 107-115 ◽  
Author(s):  
Eveline L. de Zeeuw ◽  
Catherina E. M. van Beijsterveldt ◽  
Eco J. C. de Geus ◽  
Dorret I. Boomsma

The main aim of this study was to examine twin specific risk factors that influence educational achievement in primary school. We included prenatal factors that are not unique to twins, except for zygosity, but show a higher prevalence in twins than in singletons. In addition, educational achievement was compared between twins and their nontwin siblings in a within-family design. Data were obtained from parents and teachers of approximately 10,000 twins and their nontwin siblings registered with the Netherlands Twin Register. Teachers rated the proficiency of the children on arithmetic, language, reading, and physical education, and reported a national educational achievement test score (CITO). Structural equation modeling showed that gestational age, birth weight, and sex were significant predictors of educational achievement, even after correction for socioeconomic status. Mode of delivery and zygosity did not have an effect, while parental age only influenced arithmetic. Mode of conception, incubator time, and birth complications negatively affected achievement in physical education. The comparison of educational achievement of twins and singletons showed significantly lower ratings on arithmetic, reading, and language in twins, compared to their older siblings, but not compared to their younger siblings. Low gestational age and low birth weight were the most important risk factors for lower educational achievement of twins in primary school. It seems that the differences observed between twins and their nontwin siblings in educational achievement can largely be explained by birth order within the family.


2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110011
Author(s):  
Kyoko Okuno ◽  
Yukihiro Kitai ◽  
Toru Shibata ◽  
Hiroshi Arai

Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP). Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions. Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions. Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.


2015 ◽  
Vol 10 (1) ◽  
pp. 89-93
Author(s):  
R Joshi ◽  
G Baral

Aims: The purpose of this study was to determine the perinatal outcome of the second twin compared to the first one. Methods: This is a hospital based comparative study of 60 pregnant women with twin pregnancy at Paropakar Maternity and Women’s Hospital, Kathmandu from 14 January 2013 to13 April 2013. Apgar score and admission to neonatal intensive care unit of the first and the second twins were studied in relation to the gestational age, chorionicity, mode of delivery, inter-delivery interval and birth weight. Mc Nemars test was used with 0.05 as the level of significance. Results: Among 60 sets of twins, Apgar score of the second twin was found to be lower than the first one (p=0.02) in general and in preterm gestation (p=0.049), dichorionic diamniotic chorionicity (p=0.012), vaginal delivery (p<0.001), inter-delivery interval of <30 minutes (p=0.007) and birth weight discordance of <30 % (p=0.014). Admission to neonatal intensive care unit was not significant (p=0.5). Conclusions: Second twin had low Apgar score and the neonatal admission rate was similar for both twins. 


2020 ◽  
Author(s):  
Marcus Valerius da Silva Peixoto ◽  
Andrezza Marques Duque ◽  
Allan Dantas dos Santos ◽  
Shirley Verônica Melo Almeida Lima ◽  
Caíque Jordan Nunes Ribeiro ◽  
...  

ABSTRACTBackgroundCerebral palsy is the main cause of physical disability in childhood.ObjectivesThis study analyzed prenatal and perinatal risk factors that contribute to cerebral palsy in Brazilian children.MethodsA case-control study was conducted with 2- to 10-year-old children in the city of Aracaju, Sergipe, Brazil. The cases were population-based, selected from the Primary Health Care services. The controls were selected from the database of the Brazilian Live Births Information System. Controls were paired with cases by gender, year, and hospital of birth.ResultsA total of 570 participants (114 cases and 456 controls) were studied. Most of the participants were male, with bilateral spastic cerebral palsy. Among the prenatal factors examined, the presence of congenital anomalies was significantly different between cases and controls (OR = 54.28, [95% CI 12.55, 234.86]). The analysis of perinatal factors revealed significant differences between cases and controls in low birth weight (OR = 3.8, [95% CI 2.34, 6.16]), preterm birth (OR = 2.31, [95% CI 1.41, 3.80]), and low Apgar scores (OR = 14.73, [95% CI 5.27, 41.15]).ConclusionsThe main prenatal and perinatal factors associated with cerebral palsy in our population were congenital anomalies, low Apgar scores, low birth weight, and preterm birth. The perinatal period had more risk factors, demanding a deeper study of their causes and of possible preventive measures.


2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Agnieszka Chmielarczyk ◽  
Jadwiga Wójkowska-Mach ◽  
Dorota Romaniszyn ◽  
Paweł Adamski ◽  
Ewa Helwich ◽  
...  

2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)


2017 ◽  
Vol 38 (3-4) ◽  
pp. 68
Author(s):  
Suartawan Suartawan ◽  
Hamid HA

The rate of morbidity due to infection including nosocomial infection during neonatal period is higher than that due to other causes. The purpose of this study was to know the incidence and risk factors of nosocomial infection. This study was conducted on all babies treated at the neonatal unit, Sanglah General Hospital, Denpasar during the period of April-June 1995. Chi square test was used to compare nosocomial infection between birth weight groups and mode of deliveries. The incidence of nosocomial infections in this study was 6%, with male to female ratio of 1.6:1. Skin infections were found most frequently. This occurrence of nosocomial infection was significantly related to the birth weight and mode of delivery, in which the risk of nosocomial infection was greater in babies with low birth weight and delivered by cesarean section or other obstetric procedures.


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