Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Westmead, NSW, Australia.
Cerebral Palsy Alliance Research Institute, The University of Sydney, Camperdown, NSW, Australia.
Dev Med Child Neurol. 2020 Apr;62(4):463-469. doi: 10.1111/dmcn.14456. Epub 2020 Jan 6.
To determine the proportion of children with cerebral palsy (CP) who had major congenital anomalies, describe the types of disorders, and report on the children's functional outcomes.
Data were extracted from the Bangladesh Cerebral Palsy Register (BCPR). Descriptive analyses were conducted on children with CP and major congenital anomalies. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to measure the association between major congenital anomalies, clinical severity, and presence of comorbidities.
Between January 2015 and December 2016, 726 children with CP were newly registered with the BCPR (277 females, 449 males; mean age [SD] at registration 90mo [54mo], 4mo-18y). Seventy-eight children (11%) had a major congenital anomaly. Neurological (86%) and musculoskeletal congenital anomalies (10%) were the most common. Microcephaly was the most common congenital anomaly (83%). The odds of severe functional motor limitations (OR=2.4, 95% CI=1.9-2.9), epilepsy (OR=1.6, 95% CI=1.1-2.1), visual impairment (OR=2.6, 95% CI=2.0-3.2), presence of strabismus (OR=3.9, 95% CI=3.8-4.4), hearing (OR=1.2, 95% CI=0.6-1.9), speech (OR=5.4, 95% CI=4.6-6.2), and intellectual impairments (OR=2.3, 95% CI=1.8-2.8) were higher in children with congenital anomalies compared to children without.
The proportion of children with major congenital anomalies in the BCPR (11%) was lower than that identified in higher-income countries. This may be because of differences in how congenital anomalies are diagnosed as well as the impact of survival bias. In Bangladesh, children with CP and major congenital anomalies are more likely to have severe functional motor limitations and associated comorbidities.
Eleven per cent of children with cerebral palsy (CP) in Bangladesh had major congenital anomalies. Neurological and musculoskeletal congenital anomalies were the most common. Severe functional motor limitations and associated comorbidities were more common in children presenting with CP and major congenital anomalies.
确定脑瘫（CP）患儿中伴有重大先天性异常的比例，描述疾病类型，并报告患儿的功能结局。
从孟加拉国脑瘫登记处（BCPR）中提取数据。对伴有重大先天性异常的 CP 患儿进行描述性分析。使用比值比（OR）及其 95%置信区间（CI）来衡量重大先天性异常、临床严重程度和并存疾病之间的关联。
2015 年 1 月至 2016 年 12 月，BCPR 新登记了 726 名 CP 患儿（女性 277 名，男性 449 名；登记时的平均年龄[标准差]为 90 个月[54 个月]，4 个月-18 岁）。78 名患儿（11%）存在重大先天性异常。神经（86%）和骨骼肌肉先天性异常（10%）最为常见。小头畸形是最常见的先天性异常（83%）。严重运动功能受限（OR=2.4，95%CI=1.9-2.9）、癫痫（OR=1.6，95%CI=1.1-2.1）、视力障碍（OR=2.6，95%CI=2.0-3.2）、斜视（OR=3.9，95%CI=3.8-4.4）、听力障碍（OR=1.2，95%CI=0.6-1.9）、言语障碍（OR=5.4，95%CI=4.6-6.2）和智力障碍（OR=2.3，95%CI=1.8-2.8）的风险在伴有先天性异常的患儿中更高。
BCPR 中伴有重大先天性异常的 CP 患儿比例（11%）低于高收入国家的报告。这可能是由于先天性异常的诊断方式不同，以及生存偏差的影响。在孟加拉国，伴有 CP 和重大先天性异常的患儿更可能出现严重的运动功能受限和相关并存疾病。
孟加拉国 11%的 CP 患儿存在重大先天性异常。神经和骨骼肌肉先天性异常最为常见。伴有 CP 和重大先天性异常的患儿更易出现严重的运动功能受限和相关并存疾病。
