Maternal and foetal risk factors of cerebral palsy among Iraqi children. A case control study

Abstract

Background: The importance of studying cerebral palsy comes from the fact that, this disorder imposes huge burden families psychologically, emotionally, financially and socially. Moreover, it imposes a major burden on the National Health System because it is simply a chronic disorder, which needs a continuous care and multiple financial resources. At the same time, it needs collaborative efforts and team work between many parties and organizations for a good management and rehabilitation. In Iraq, risk factors of cerebral palsy have not been explored before. Our study objective was to measure the association between, maternal factors, foetal and early neonatal factors, and occurrence of cerebral palsy among Iraqi children. Postnatal risk factors of cerebral palsy were excluded in our study. Methods: We did a retrospective case-control study in Baghdad-Iraq. The place of study was The Central hospital of Children of Baghdad. Cases and controls were fully investtigated (retrospectively) for the risk factors of cerebral palsy using a self-administered questionnaire. The sample size was 300. Number of cases in our study was 100 while the number of controls in our study was 200. Results and conclusion: 84% of the mothers of Cerebral Palsy children were employed compared to 49% of the mothers of normal children who were employed (P value 0.00). After using a multiple logistic regression model, the final adjusted odd ratios included 6 variables which were, employment of mother (OR 8.05, 95% CI 0.98 - 6.62), Primigravida(OR 0.24, 95% CI 0.10 - 0.60), gender of the child(OR 0.15, 95% CI 0.04 - 0.51 ), asphyxia (OR 10.58, 95% CI 3.59 - 31.21), hypoglycemia (OR 40.99, 95% CI 6.93 - 242.27) and hypocalcaemia (OR 27.91, 95% CI 2.04 - 380.96). Our study came to a conclusion that neonatal asphyxia, hypoglycemia and hypocalcaemia were still the major risk factors for cerebral palsy In Iraq

A study on maternal and perinatal risk factors of cerebral palsy among children attending a cerebral palsy clinic in Visakhapatnam

“…4,6 In our study pregnancy induced hypertension amounts to 9% which is higher than that of a study done by Gowda et al, Pattar et al study, Saadi et al 6,7,12 Gestational diabetes is seen in 7% of mothers in our which was similar to that found in to that seen in Saadi et al 7 Among the probable etiologic factors in the present study, perinatal factors were the most prevalent. However in a few cases, more than one probable cause was taken into account, as it was difficult to pin point one etiological agent.…”

“…[3][4][5] In our study consanguinity amounts to 38% which is similar to that found in the study done by Gowda et al and Saadi et al which was comparable with few Turkish studies who have noted a high number of marriages between relatives (21% of all marriages). [6][7][8][9] The increased frequency of consanguinity among parents of children with CP, and the strong association with a positive family history suggests the role of genetic factors in the pathogenesis of CP in this environment.…”

Risk Factors for Cerebral Palsy in Brazilian Children: A Case-Control Study

“…2,5 In addition to the multifactorial clinical aspects, the causes of CP can also be related to healthcare management and quality. 6 A systematic review reported a prevalence of 2.11 per 1,000 live births. 7 The low prevalence of CP makes it difficult to identify risk factors.…”

“…8 Most of the epidemiological studies on CP were conducted in developed countries, 4,7,9,10 despite efforts by researchers from various developing countries. 6,[11][12][13][14][15][16] An increased risk of cerebral palsy in low-and middle-income countries, due to exposure to perinatal events, has been suggested. 2,17 The epidemiological aspects of CP need further clarification, especially in socioeconomic contexts characterized by social inequities.…”

“…2,5 In addition to the multifactorial clinical aspects, the causes of CP can also be related to healthcare management and quality. 6…”