Risk Factors of Cerebral Palsy among Children Registered in a Self Help Group for Cerebral Palsy

Abstract

A case control study was conducted to determine risk factors of cerebral palsy. Fifty children with cerebral palsy registered at a Self Help Group for Cerebral Palsy as cases and 100 age and sex matched controls from immediate neighbourhood of cases were studied. All cases and controls were aged six months to 10 years and residing in Kathmandu valley. Information regarding antenatal, natal and postnatal period was collected by interviewing mothers of cases and controls at their houses and from hospital records of the study subjects where available. 

Forty four percent of cases had associated seizure disorder, 22.0% cases had speaking problem and 14.0% cases were mentally retarded. Most common type of cerebral palsy was spastic diplegia (30.0%). Birth asphyxia was found to be present among 48% of cases, 24.0% cases had birth weight of less than 2500 gm and 16.0% cases developed neonatal jaundice. Neonatal sepsis was present in 36.0% cases. The significant risk factors identified with logistic regression were birth asphyxia (odds ratio 21.6), neonatal sepsis (odds ratio 20.8), neonatal jaundice (odds ratio 8.3) and low birth weight (odds ratio 7.1). Study concludes that birth asphyxia, low birth weight, neonatal jaundice and neonatal sepsis tend to be risk factors of cerebral palsy. As these risk factors are modifiable, the burden of cerebral palsy can be reduced by preventing these risk factors. Similarly follow up for high-risk cases and early rehabilitative intervention can limit the disability among cases.