Advertisement

The Indian Journal of Pediatrics

, Volume 64, Issue 5, pp 677–685 | Cite as

Risk factors for cerebral palsy

  • Sahu Suvanand
  • S. K. Kapoor
  • V. F. Reddaiah
  • U. Singh
  • K. R. Sundaram
Original Article

Abstract

Cerebral palsy is a major cause of crippling in children, but it’s etiology is poorly understood. This case control study was done to assess some of the identified risk factors for cerebral palsy. 125 cerebral palsy cases selected from hospital clinic and 125 age and sex matched neighbourhood controls, all aged less than 5 years and residing in Delhi (India) were studied. Information regarding antenatal, natal and postnatal period was collected by mother’s interview, and wherever available, from hospital records with the study subjects. Most common type of cerebral palsy was spastic (88%). Quadriplegia was the commonest topographical subtype (86.4%). Birth asphyxia was found to be present in only 25.6% of cases. The commonest risk factor amongst cases was low birth weight (28.8%). The multivariate odds ratios (confidence limits) for the risk factors found to be significantly associated with cerebral palsy were 36.1 (7.76 – 160) for birth asphyxia, 13.8 (4.95 ‱ 38.3) for low birth weight, 37.4 (4.47 ‱ 313) for neonatal convulsion, 23 (4.7 ‱ 112) for neonatal jaundice, 14.4 (3.69 ‱ 56.4) for neonatal infection, 24.9 (2.78 ‱ 223) for instrument assisted delivery and 15.4 (1.57 ‱ 152) for antepartum hemorrhage. Precipitate labour, caesarean section, twins, toxemia, breech delivery and head injury were not found to be significantly associated with cerebral palsy. Thus birth asphyxia, low birth weight, neonatal convulsions, neonatal jaundice, neonatal infection, instrument assisted delivery and antepartum hemorrhage are significant risk factors for cerebral palsy.

Key words

India Cerebral palsy Etiology Risk factors Case-control study 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Stanley FJ, Watson L. Trends in perinatal mortality and cerebral palsy in western Australia, 1967 to 1985.Br Med J 1992; 304: 1658–1662.Google Scholar
  2. 2.
    Pharoah POD, Cooke T, Rosenbloom I, Cooke RWI. Trends in birth prevalence of cerebral palsy.Arch Dis Child 1987; 62: 379–384.PubMedGoogle Scholar
  3. 3.
    Jarvis SN, Holloway JS, Hey EN. Increase in cerebral palsy in normal birth weight babies,Arch Dis Child 1987; 62: 1113–1121.Google Scholar
  4. 4.
    Phelps WM. The rehabilitation of cerebral palsy.South Med J 1941; 34: 770.Google Scholar
  5. 5.
    Levin ML,. Brightman EJ. The problem of cerebral palsy.New York J Med 1949; 49:2793.PubMedGoogle Scholar
  6. 6.
    Woods GE. A lowered incidence of infantile cerebral palsy.Dev Med Child Neurol 1963; 5: 449.CrossRefGoogle Scholar
  7. 7.
    Rosen MG, Dickinson JC. The incidence of cerebral palsy.Am J Obstet and Gynecol 1992; 167 (2): 417–423.Google Scholar
  8. 8.
    Little WJ. On the influences of abnormal parturition, difficult labours, premature birth and asphyxia neonatorum, on the mental and physical condition of the child, especially in relation to deformities.Trans Obstet Soc London 1862; 3: 293–344.Google Scholar
  9. 9.
    Nelson KB, Ellenberg JH. Antecedents of cerebral palsy. Multivariate analysis of risk.N Eng J Med 1986; 315:81–86.CrossRefGoogle Scholar
  10. 10.
    Naeye RL,. Peters EC, Barholomew M, Landis JR. Origins of cerebral palsy.Am J Dis Child 1989; 143:1154–1161.PubMedGoogle Scholar
  11. 11.
    Stanley FJ, Blair E. Why have we failed to reduce the frequency of cerebral palsy?Med J Aust 1991; 154: 623–626.PubMedGoogle Scholar
  12. 12.
    Pharoah POD, Cooke T, Cooke RWI, Rosenbloom L. Birthweight specific trends in cerebral palsy.Arch Dis Child 1990; 65:602–606.PubMedGoogle Scholar
  13. 13.
    Dale A, Stanley FJ. An epidemiological study of cerebral palsy in western Australia, 1956-1975 II: Spastic cerebral palsy and perinatal factors.Dev Med Child Neurol 1980; 22 :13–25.PubMedCrossRefGoogle Scholar
  14. 14.
    Basu B. Cerebral palsy in childhoodJ Indian Med Assoc 1967; 49: 477–482.PubMedGoogle Scholar
  15. 15.
    Srivastaya VK, Laisram N, Srivastava RK. Cerebral palsy.Indian Pediattics 1992; 29:993–996.Google Scholar
  16. 16.
    O’Relilly DE, Walentynowicz JE. Etiological factors in cerebral palsy: an historical review.Dev Med Child Neurol 1981; 23 : 633–642.Google Scholar
  17. 17.
    Nelson KB, Ellenberg JH. Antecedents of cerebral palsy. Univariate analysis of risks.Am J Dis Child 1985; 139: 1031–1038.PubMedGoogle Scholar
  18. 18.
    Eastman NJ, DeLeon M. The etiology of cerebral palsy.Am J Obst Gynecol 1955 ; 69:950.Google Scholar
  19. 19.
    Powell TG, Pharoah POD, Cooke RWI, Rosenblom L. Cerebral palsy in low birth weight infants, I spastic hemiplegia: Association with intrapartum stress.Dev Med Child Neurol 1988; 30 :11–18.PubMedCrossRefGoogle Scholar
  20. 20.
    Powell TG, Pharoah POD, Cooke RWI, Rosenbloom L. Cerebral palsy in low birth weight infants. II spastic diplegia: Associations with fetal immaturity.Dev Med Child Neurol 1988; 30 :19–25.PubMedCrossRefGoogle Scholar
  21. 21.
    Ellenberg JH, Nelson KB. Birthweight and gestational age in children with cerebral palsy or seizure disorders.Am J Dis Child 1979; 133:1044–1048.PubMedGoogle Scholar
  22. 22.
    Schlesselman. J J.Case control studies. New Oxford University press : 145; 160–162.Google Scholar
  23. 23.
    Pharoah POD, Cooke T, Rosenbloom L. Cooke RWI. Effects of birth weight, gestational age and maternal obstetric history on birth prevalent of cerebralpalsy.Arch Dis Child 1987; 62: 1035–1040.PubMedGoogle Scholar
  24. 24.
    Chandra R, Srivastva AK, Mishra PC, Rahman H, Sharan R, Cerebral palsy.J Indian Med Assoc 1993; 91 (9): 236–237.PubMedGoogle Scholar
  25. 25.
    Torfs CP, Van den Berg BJ, Oechsli FW, Cummins S. Prenatal and perinatal factors in the etiology of cerebral palsy.J Pediatr 1990; 116: 615–619.PubMedCrossRefGoogle Scholar
  26. 26.
    Ozmen M, Caliskan M, Apak S, Gokcay G. 8 year clinical experience in cerebral palsy,J Trop Pediatr 1993; 39 (1): 52–54.PubMedGoogle Scholar
  27. 27.
    Fletcher NA, Foley J. Paternal age. Genetic mutation and cerebral palsy.J Med Genetics 1993; 30 (1): 44–46.Google Scholar
  28. 28.
    Cummins K. Nelson KB. Grether JK Velie EM. Cerebral palsy in four northern California counties, births 1983 through 1985.J Pediatr 1993; 123: 230–237.PubMedCrossRefGoogle Scholar
  29. 29.
    Ramar S. Cerebral palsy in children can be prevented.Indian J of Physical Medicine and Rehabilitation 1993; 6(2): 7–9.Google Scholar
  30. 30.
    Eicher PS, Batshaw ML. Cerebral palsy.Pediatr Clin North Am 1993; 40 (3): 537–551.PubMedGoogle Scholar
  31. 31.
    Blair E, Stanley FJ. Intrapartum asphyxia: A rare cause of cerebral palsy.J Pediatr 1988; 112 : 515–519.PubMedCrossRefGoogle Scholar
  32. 32.
    Petterson B, Nelson KB, Watson L, Stanley F. Twins, triplet and cerebral palsy in births in western Australia in the 1980s.Br Med J 1993; 307:1239–1243.CrossRefGoogle Scholar
  33. 33.
    Grether JK, Nelson KB, Cummins SK. Twining and cerebral palsy: experience in four northern Californa counties, births 1983 through 1985,Pediatrics 1993 December; 92 (6) : 854–858.PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 1997

Authors and Affiliations

  • Sahu Suvanand
    • 1
  • S. K. Kapoor
    • 1
  • V. F. Reddaiah
  • U. Singh
  • K. R. Sundaram
    • 2
  1. 1.Center for Community MedicineAll Indian Institute of Medical Sciences (AIIMS)New Delhi
  2. 2.Department of Physical MedicineAll Indian Institute of Medical Sciences (AIIMS)New Delhi

Personalised recommendations