Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

Jahan, Israt; Sultana, Risad; Muhit, Mohammad; Akbar, Delwar; Karim, Tasneem; Imam, Mahmudul Hassan Al; Das, Manik Chandra; Smithers‐Sheedy, Hayley; McIntyre, Sarah; Badawi, Nadia; Khandaker, Gulam

doi:10.3390/nu14061211

Cited by 14 publications

(16 citation statements)

References 52 publications

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“…Furthermore, hematologic disorders as a comorbidity were found to be an independent risk factor for the development of infectious complications on multivariable analysis. Previous research investigating the correlation between hematologic status and postoperative infections in pediatric patients with CP is limited, however, malnutrition and feeding disorders are significantly more common in children with CP 21 . This may account for the increased prevalence of hematologic issues like vitamin D deficiency and diabetes mellitus seen in this population 22,23 .…”

Section: Discussionmentioning

confidence: 99%

“…Previous research investigating the correlation between hematologic status and postoperative infections in pediatric patients with CP is limited, however, malnutrition and feeding disorders are significantly more common in children with CP. 21 This may account for the increased prevalence of hematologic issues like vitamin D deficiency and diabetes mellitus seen in this population. 22,23 Therefore, the importance of optimizing preoperative nutrition and consequently immune function and hematology status in patients with CP should not be overlooked.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors of Infectious Complications in Pediatric Patients With Cerebral Palsy After Spinal Arthrodesis

Miśkiewicz

Perea

Magruder

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Objective:The main objective of this study was to investigate (1) whether pediatric patients with cerebral palsy (CP) have higher rates of postoperative infectious complications after spinal fusion and (2) risk factors for postoperative infections.Summary of Background Data: Prior studies have shown that patients with CP undergo corrective spine surgery more often than the general population, yet typically have worse postoperative outcomes. Further investigation is needed to improve our understanding of the perioperative factors that place children with CP at greater risk of postoperative infectious complications.Patients and Methods: The 2019 "American College of Surgeons National Surgical Quality Improvement Program" Pediatric database was used for patient data. The univariable analysis compared the prevalence of preoperative comorbidities and perioperative factors between children with and without CP. Multivariable logistic regression modeling was used to ascertain independent risk factors for postoperative infectious complications.Results: A total of 4445 patients were included in the study; 606 (13.63%) patients had CP and 3839 (86.37%) did not. Patients with CP were more likely to have several notable preoperative comorbidities, and the rate of developing any infectious complication was more than 7 times greater in the CP cohort than in the control cohort (14.36% vs 1.88%; P < 0.001). Multivariable analysis revealed CP [odds ratio (OR): 3.55, CI: 2.25-5.60; P < 0.001], American Society of Anesthesiologists class 3 or higher (OR: 2.10, CI: 1.29-3.42; P = 0.003), and hematologic disorders (OR: 2.01, CI: 1.06-3.83; P = 0.033) to be independent risk factors for increased postoperative infectious complications.Conclusions: CP is an independent risk factor for the development of 30-day postoperative infectious complications in pediatric patients. In addition, the American Society of Anesthesiologists class 3 or higher and hematologic disorders were risk factors for postoperative infections after spinal fusion surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors of Infectious Complications in Pediatric Patients With Cerebral Palsy After Spinal Arthrodesis

Miśkiewicz

Perea

Magruder

et al. 2023

Clinical Spine Surgery: A Spine Publication

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“…Specifications on feeding and positioning, growth monitoring, dietary and energy requirements by ambulatory status should be included as this has been proven effective [ 54 ]. Implementation requires a multidisciplinary approach that includes, training on physical rehabilitation, and knowledge of disability among community health workers, and integration of trained caregivers of children with CP into the lay community health workforce or village health teams.…”

Section: Discussionmentioning

confidence: 99%

Nutritional status and growth of children and adolescents with and without cerebral palsy in eastern Uganda: A longitudinal comparative analysis

Namaganda

Andrews

Wâbwire-Mângen

et al. 2023

PLOS Glob Public Health

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There is a need to understand the growth and burden of malnutrition in children with cerebral palsy (CP) in order to design appropriate inclusive nutrition strategies. We compared the nutritional status and four-year longitudinal growth of a population-based cohort of children and adolescents (C&A) with CP (n = 97; 2–17 years; 55/42 M/F), and an age and sex matched group without CP (n = 91; 2-17y; 50/41 M/F) in rural Uganda. The cohorts were assessed in 2015 and 2019 for weight, height, social demographic characteristics, and feeding related factors. Nutritional status was determined using the World Health Organization (WHO) Z-scores. Wilcoxon sign rank and Mann-Whitney tests were used to test within and between group differences. Multivariable linear regression was used to determine predictors of the change in growth. Approximately two thirds (62/97 (64%)) of C&A with CP were malnourished (with <-2SD in any of the WHO Z-scores), especially those with feeding difficulties (OR = 2.65; P = 0.032), and those who needed to be fed (OR = 3.8; P = 0.019). Both the CP and non-CP groups deviated negatively from the WHO reference growth curve for height, with a significantly slower growth in the CP group (median change score of height-for-age Z score (HAZ) between assessments = -0.80(-1.56, 0.31), p<0.01), than the non-CP group (median HAZ change score = -0.27(-0.92,0.34, p = 0.034). There was a statistically significant group difference in the median HAZ change score between the CP and non-CP groups (z = -2.21, p = 0.026). Severity of motor impairment measured by the Gross Motor Function Classification System (GMFCS-level) correlated negatively (r = -1.37,95%CI -2.67, -0.08) with the change in HAZ scores among the CP group. Children and adolescents with severe motor impairments exhibit an increased risk of malnutrition and growth retardation compared to their age matched peers without CP, which underscores the need to develop inclusive community-based nutrition strategies for children with cerebral palsy.

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“…It has attracted the attention of policymakers and politicians due to its serious effects on the nation’s health and economy ( 1 - 4 ). Malnourished children are more susceptible to infections, which leads to higher morbidity and mortality among children from certain diseases ( 1 , 3 , 5 - 7 ). Reasonable dietary nutrition for children is the basis for their healthy growth ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

“…It will directly determine the physical and mental health of children in the future ( 2 ). In the long term, it will also affect a country’s economic development and overall national strength ( 2 , 3 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of nutritional interventions on the physical development of preschool children: a systematic review and meta-analysis

Shi¹,

Ren²,

Jia³

2023

Transl Pediatr

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Background There is a significant correlation between diet and delayed growth and development in children. However, the evidence for the crucial role of dietary interventions in children’s growth and development health remains inconclusive. This meta-analysis sought to comprehensively evaluate the effects of nutritional interventions on children’s physical development. Methods Articles published from January 2007 to December 2022 were retrieved from the PubMed, Embase, Cochrane Library, Wanfang, and China National Knowledge Infrastructure (CNKI) databases. Statistical analysis was conducted using Stata/SE 16.0 software, as well as Review Manager 5.4 software. Results The meta-analysis included a total of 8 original studies. The total sample comprised 6,645 children aged <8 years. The results of meta-analysis were as follows: (I) there was no significant difference in the body mass index (BMI)-for-age z scores between the nutritional intervention group and the control group [mean difference (MD) =0.12, 95% confidence interval (CI): –0.07, 0.30]. Thus, the nutritional interventions did not significantly improve the BMI-for-age z scores; (II) when the nutritional intervention period was <6 months, there was no significant difference in the weight-for-height z scores between the nutritional intervention group and the control group (MD =0.47, 95% CI: –0.07, 1.00), but when the nutritional intervention period was ≥6 months, the nutritional interventions significantly improved the weight-for-height z scores (MD =0.36, 95% CI: 0.00, 0.72); (III) a nutritional intervention period ≥6 months cannot significantly improved children’s height-for-age z scores; (4) When the nutritional intervention period was <6 months, there was no statistically significant difference in the weight-for-age z scores between the nutritional intervention group and the control group (MD =–0.20, 95% CI: –0.60, 0.20), but when the nutritional intervention period was ≥6 months, the nutritional interventions significantly increased children’s weight-for-age (mean difference =2.23, 95% CI: 0.01, 4.44). Conclusions Different nutritional interventions had a slight improvement effect on children’s physical growth and development. However, the effect of the short-term nutritional interventions (<6 months) was not obvious. In clinical practice, it is recommended that nutritional intervention programs be formulated that can be implemented for longer periods. However, due to the limited literature included, further research is needed.

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Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

Cited by 14 publications

References 52 publications

Risk Factors of Infectious Complications in Pediatric Patients With Cerebral Palsy After Spinal Arthrodesis

Risk Factors of Infectious Complications in Pediatric Patients With Cerebral Palsy After Spinal Arthrodesis

Nutritional status and growth of children and adolescents with and without cerebral palsy in eastern Uganda: A longitudinal comparative analysis

Effects of nutritional interventions on the physical development of preschool children: a systematic review and meta-analysis

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