Exploring the Factors Associated with Cerebral Palsy of Children

Abstract

A cross sectional retrospective survey was conducted at the Center for Rehabilitation of the Paralyzed (CRP) to investigate risk factors in children with Cerebral Palsy (CP). Purposive sampling was used to select total 310 consecutive children with CP, who were rehabilitated in the pediatric in-patient clinic between March 2011 to September 2011. Factors affecting CP were investigated by scanning case history section of participants' medical files. Information of each case history section was obtained through interviewing the families. Risk factors were recorded as consanguineous marriage, maternal complication during pregnancy, birth history (preterm birth/ term/ post term), birth injury, birth asphyxia, neonatal convulsion, postnatal illness and some socioeconomic factors (gender, geographical location, parents education and employment), which define difficulty to accessing health services and have consequences on disability. There were more males (61 %) than females (39%) among children with CPo Their age range was between 9 months to 11 years (the mean age was 4.00l±2.3025 years). The most frequently encountered risk factors were, birth asphyxia (74%) and seizures after birth (58.1 %). 37.4% of births were attended by a doctor, 21.6% attended by a nurse or midwife and 41 % attended by traditional birth attendants. 133 (42.9%) children were brought to a health center for seeking treatment when they were between 2-4 years of age. In terms of seeking treatment for these children geographical location of them has influence. 42.6% children were from Dhaka which is the closest among all division because CRP is located in Dhaka city and the rest of the children were from other five divisions. Parents (mother and father) who had 10 years of education brought their children earlier to health center. 50% of total children with CP in this study were first in their birth order. 7.10% of mother had hypertension, 9% of mothers had anemia and 31.60% of mothers had other complications such as amino fluid losS, fever and history of falling down etc. Labor period and gestational term were not found to be significant risk factors. Compared to other evidence consanguine marriage was not found as a prominent factor in this study. After birth participants of the study had some common complications like jaundice 25.5%, pneumonia 35.5 %, dehydration 7.7%, and other illnesses 18.1 %. 9.4% of children had hearing difficulties and 17.7% had visual impairment associated with CP This study identified birth asphyxia and seizure after birth as direct risk factors for CP, and socioeconomic factors as having indirect influence on the cause of CP