Antenatal and intrapartum risk factors of children with cerebral palsy

Abstract

Purpose: The aim of the study was to identify common antenatal and intrapartum risk factors among the Children with Cerebral Palsy (CP). Objectives: To identify and analyse possible antenatal and intrapartum risk factors affecting the development of cerebral palsy. Methodology: Antenatal and intrapartum events were compared between 25 children with CP case and 25 control in a retrospective case-control method. Antenatal and intrapartum factors were expressed as odds ratios, 95% confidence intervals and chi-square test. Factors associated with an increased risk of CP identified as antenatal and intrapartum risk factors were: maternal eclampsia, maternal hypertension, maternal diabetes, physical problem (e.g. fall down), maternal viral diseases, low birth weight(< 2500 gm), delayed crying, birth asphyxia, neonatal seizures were associated with an increased risk of CP in the neonatal period. Results: Data was analyzed by using SPSS version 20 and odds ratio was used. Microsoft Excel Work sheet 2013 and had a two group case and control. A total of 50 participants with cerebral palsy minimum age group of mother were 18 years and maximum age was 35 years. Among case the mean age of the participants was 26.5 years and boy ratio 54% and girl ratio 46%. Highest mother education were primary 46% (n=23). The frequency of child born in area there are 42% (n=22) home, 22% (n=11) born hospital, 36% (n=18) born clinic and their physical problem 22.0% (n=11) fall down, 16% (n=8) weight lifting, 10% (n=5) traumatic, no related cause 52% (n=26). The factors significantly associated with the cerebral palsy were antenatal care (OR- 1.833; 95% CI, 0.387-8.674, chi-0.22,P>0.05), Maternal Eclampsia (OR 1.313; 95% CI, 0.308-5.598, chi-0.13, P >0.05), Medicine taken during pregnancy (OR 3.188; 95% CI, 0.99-10.17, p<0.05) cerebral palsy which is statistically significant , Physical problem (OR 5.76; 95% CI, 1.36- 24.36, chi-6.34, Abstract p<0.05), cerebral palsy which is statistically significant, maternal hypertension (OR- 11.15; 95% CI 2.86 to 43.46, p<0.05) cerebral palsy which is statistically significant. Maternal diabetes (OR 13.5; 95% CI- 3.55- 51.22, p<0.05) statistically significant. Birth weight (OR 46.00; 95% CI-8.02-263.62, p<0.05) cerebral palsy which is statistically significant. Delayed crying (OR .80; 95% CI-0.016-0.416; Chi-11.52 p<0.05), Birth asphyxia (Chi-10.976, p<0.05), Neonatal seizure (Chi-21.42; p<0.05) cause of cerebral palsy which is statistically significant. Illness or infection of child after birth (OR 3.778; 95% CI- 1.170 -12.194; Chi-5.128; p<0.05) which means 3.778 higher risk factor for cerebral palsy. Conclusion: Study demonstrated that perinatal asphyxia, child birth weight, delayed crying and any pathology during pregnancy were independent factors associated with CP in term newborns.