Risk Factors for Cerebral Palsy in Children in Botswana

Monokwane, Baphaleng; Johnson, Allison; Gambrah-Sampaney, Claudia; Khurana, Esha; Baier, James; Baranov, Esther; Westmoreland, Kate; Mazhani, Loeto; Steenhoff, Andrew P.; Bearden, David

doi:10.1016/j.pediatrneurol.2017.07.014

Cited by 21 publications

(25 citation statements)

References 21 publications

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“…15,16 The association between different types of maternal infection, for example, bacterial, viral, and parasitic, have been investigated in the previous studies. 10,17 -19…”

mentioning

confidence: 99%

Maternal Infection During Pregnancy and Risk of Cerebral Palsy in Children: A Systematic Review and Meta-analysis

2020

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Background and aim: The association between maternal infection during pregnancy and the risk of cerebral palsy has been previously reported. However, their results were relatively inconsistent. This systematic review and meta-analysis were carried out to investigate the association between maternal infection during pregnancy and the risk of cerebral palsy in children. Methods: PubMed, Scopus, and Web of Sciences databases were searched from inception to October 28, 2019. Heterogeneity was assessed using the I2 value. In case of substantial heterogeneity (I2 > 50%), a random effects model was applied, otherwise, a fixed effects model was used. The pooled associations were expressed as relative risks (RRs) and 95% confidence intervals (CIs). Publication bias and quality of studies included in the systematic review were checked using the Egger’s regression test and Newcastle-Ottawa Scale (NOS), respectively. Results: Thirty-seven studies were included in the systematic review. Among them, 21 studies were eligible for the meta-analysis. The pooled RR of cerebral palsy risk was 2.50 (95% CI 1.94, 3.21; I2 = 88.7%, P < .001) among children born to mothers who had any infection during pregnancy. The risk was increased to 2.85 (95% CI 1.96, 4.15; I2 = 75.9%, P < .001) when the mother was diagnosed with chorioamnionitis. Publication bias tests suggested no evidence of potential publication bias and 76% of the studies included in the meta-analysis were of high quality (NOS ≥ 6). Conclusion: This systematic review and meta-analysis provides evidence that maternal infection during pregnancy may be associated with an increased risk of cerebral palsy in children.

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“…15,16 The association between different types of maternal infection, for example, bacterial, viral, and parasitic, have been investigated in the previous studies. 10,17 -19…”

mentioning

confidence: 99%

Maternal Infection During Pregnancy and Risk of Cerebral Palsy in Children: A Systematic Review and Meta-analysis

2020

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“…A study from Botswana in 2017 showed that significant risk factors for CP included serious neonatal infections, complications during delivery, and maternal human immunodeficiency virus (HIV). The study concluded that the major risk factors for CP in Botswana differ from those described in high-resource settings [9].…”

Section: Introductionmentioning

confidence: 82%

“…Both the Kristeller manoeuvre and in atable belts are still frequently used in obstetric practice in Moldova. A 2017 systematic review in the Cochrane Database [9] concluded that evidence from randomised controlled trials was insu cient to show whether manual fundal pressure or fundal pressure by in atable belt have a severely harmful impact on the baby. However, some of the studies showed a decrease in the ve-minute Apgar score.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for cerebral palsy in Moldova

Bufteac

Jahnsen

Spinei

et al. 2020

Preprint

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Abstract BackgroundThis is the first study assessing risk factors for cerebral palsy (CP) among children born in Moldova.MethodsWe identified 351 children with CP born during 2009 and 2010 in state hospitals, maternity wards, orphanages and rehabilitation centres in Moldova. Detailed information on 417 children without CP (of the total number of 81,277 children) served as a reference group. Logistic regression analyses were applied to calculate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) in addition to attributable risk (AR).ResultsAmong children with CP (40.5% girls), 26% had unilateral, 54% bilateral, 13% dyskinetic, and 5% ataxic CP, with 2% unclassified. Almost three quarters of children with CP were from rural areas and 101 (29%) were prematurely born.Significant risk factors for CP included low Apgar score at five minutes (OR 6.187, 95% CI 2.059–18.59), hyperbilirubinemia (OR 6.3, 95% CI 4.1–9.6), breech delivery (OR 3.5, 95% CI 2–6.01), assisted vaginal delivery (OR 47, 95% CI 11–194), birth out of maternity (OR 6.591, 95% CI 1.904–22.81), low education level (OR 3.889, 95% CI 2.8–5.248), alcohol consumption (OR 1.903, 95% CI 1.269–2.885) and hypertension (OR 2.264, 95% CI 1.5–5.417).For singletons born at term, significant risk factors were low Apgar score (OR 2.115, 95% CI 1.22–3.808), hyperbilirubinemia (OR 5.854, 95% CI 3.648–9.393), breech delivery (OR 6.48, 95% CI 3.1–13.7), fundal pressure (OR 3.268, 95% CI 1.398–7.642), maternal hypertension (OR 2.248, 95% CI 1.55–3.997) and alcohol consumption (OR 2.105, 95% CI 1.315–3.369).Hyperbilirubinemia, Apgar score (0–3), birth out of maternity and breech delivery had the highest AR for CP both in the total and term singleton groups. Chronic diseases among mothers also had a high AR for CP.ConclusionsA combination of factors related to the child, the delivery and the mother were risk factors for CP among children born in Moldova, many of them possibly avoidable. The results may indicate a need for better maternal and perinatal childcare. A national CP register in Moldova is recommended as an opportunity to follow up these findings.

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“…4,16 There is an increase in the prevalence of cerebral palsy in resource-limited settings due to an increased rates of birth complications and early infections, with some studies suggesting rates several times higher than that seen in the US and Western Europe. 67 There may also be a relative increase in comorbidities such as epilepsy and intellectual disability. 4,15 As is the case with epilepsy, there may be substantial stigma attached to having a family member with cerebral palsy, resulting in decreased service utilization and fewer educational opportunities for patients with cerebral palsy.…”

Section: Cerebral Palsymentioning

confidence: 99%

Global Health: Pediatric Neurology

Bearden¹,

Ciccone

Patel

2018

Semin Neurol

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Neurologic disorders contribute significantly to both morbidity and mortality among children in resource-limited settings, but there are a few succinct studies summarizing the epidemiology of neurologic disorders in these settings. A review of available literature was performed to identify data on the prevalence, etiology, outcomes, and treatment of neurologic disorders in children in resource-limited settings. The burden of neurologic disorders in children is high in resource-limited settings. Barriers to optimal care include lack of trained personnel, limited access to diagnostic technology, and limited availability of drugs used to treat common conditions. Several solutions have been suggested to deal with these challenges including increased collaborations to train neurologists willing to practice in resource-limited settings and increased training of physician extenders or community health workers. Further studies are necessary to improve our understanding of the epidemiology of neurologic disorders in resource-limited settings. Future epidemiologic studies should incorporate multiple countries in resource-limited settings and utilize standardized definitions and methodologies to enable comparison across regions.

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Risk Factors for Cerebral Palsy in Children in Botswana

Cited by 21 publications

References 21 publications

Maternal Infection During Pregnancy and Risk of Cerebral Palsy in Children: A Systematic Review and Meta-analysis

Maternal Infection During Pregnancy and Risk of Cerebral Palsy in Children: A Systematic Review and Meta-analysis

Risk factors for cerebral palsy in Moldova

Global Health: Pediatric Neurology

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