Risk factors for intellectual disability in children with spastic cerebral palsy.
Birth Weight
Cerebral Palsy
/ classification
Child, Preschool
Cross-Sectional Studies
Female
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Small for Gestational Age
Intellectual Disability
/ epidemiology
Male
Northern Ireland
/ epidemiology
Premature Birth
/ epidemiology
Registries
Risk Factors
Term Birth
epidemiology
neurology
Journal
Archives of disease in childhood
ISSN: 1468-2044
Titre abrégé: Arch Dis Child
Pays: England
ID NLM: 0372434
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
10
08
2020
revised:
11
01
2021
accepted:
23
01
2021
pubmed:
18
3
2021
medline:
23
11
2021
entrez:
17
3
2021
Statut:
ppublish
Résumé
Cerebral palsy (CP) is a non-progressive disorder of posture and movement caused by prenatal or perinatal lesions of the brain. Children with CP are also at increased risk of other disabilities, for example, intellectual disability. Previous studies suggest the risk of intellectual disability varies in complex ways according to the type of motor impairment and perinatal factors such as gestational age. To determine the patterns of risk of intellectual disability in children with spastic CP. Cross-sectional, population-based study using the Northern Ireland Cerebral Palsy Register. Persons born in 1981-2008 with congenital bilateral or unilateral spastic CP (N=1452). The outcome measure was severe intellectual disability (IQ <50), as reported by clinicians known to the child. Data pertaining to CP subtype, sex, gestational age, birth weight and functional level were included in analyses. Severe intellectual disability was significantly more prevalent in children with bilateral spastic CP (BSCP) compared with children with unilateral spastic CP (χ² (2)=162.60, p<0.001). Compared with very preterm infants with BSCP, the risk of intellectual disability increased in moderately preterm (OR=3.97, 95% CI 1.04 to 15.23) and at-term (OR=2.51, 95% CI 1.16 to 5.44) children with BSCP. Children with BSCP are at increased risk of intellectual disability, with those born at term at the highest risk. The findings highlight the importance of early screening, particularly for children with BSCP born at term.
Sections du résumé
BACKGROUND
Cerebral palsy (CP) is a non-progressive disorder of posture and movement caused by prenatal or perinatal lesions of the brain. Children with CP are also at increased risk of other disabilities, for example, intellectual disability. Previous studies suggest the risk of intellectual disability varies in complex ways according to the type of motor impairment and perinatal factors such as gestational age.
OBJECTIVE
To determine the patterns of risk of intellectual disability in children with spastic CP.
DESIGN
Cross-sectional, population-based study using the Northern Ireland Cerebral Palsy Register.
PARTICIPANTS
Persons born in 1981-2008 with congenital bilateral or unilateral spastic CP (N=1452).
OUTCOME MEASURE
The outcome measure was severe intellectual disability (IQ <50), as reported by clinicians known to the child. Data pertaining to CP subtype, sex, gestational age, birth weight and functional level were included in analyses.
RESULTS
Severe intellectual disability was significantly more prevalent in children with bilateral spastic CP (BSCP) compared with children with unilateral spastic CP (χ² (2)=162.60, p<0.001). Compared with very preterm infants with BSCP, the risk of intellectual disability increased in moderately preterm (OR=3.97, 95% CI 1.04 to 15.23) and at-term (OR=2.51, 95% CI 1.16 to 5.44) children with BSCP.
CONCLUSIONS
Children with BSCP are at increased risk of intellectual disability, with those born at term at the highest risk. The findings highlight the importance of early screening, particularly for children with BSCP born at term.
Identifiants
pubmed: 33727240
pii: archdischild-2020-320441
doi: 10.1136/archdischild-2020-320441
pmc: PMC8461399
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
975-980Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: CK and KM have received research funding from the Medical Research Council Proximity to Discovery Scheme supporting academic–industry collaboration.
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