Bharti Namrata, Dwivedi Ajeet K, Gupta Shikha, Singh Abhishek K, Sharma Bhoopendra, Khan Imran Ahmed
Pediatrics, Baba Raghav Das Medical College, Gorakhpur, IND.
Physical Medicine and Rehabilitation, Baba Raghav Das Medical College, Gorakhpur, IND.
Cureus. 2024 Mar 7;16(3):e55753. doi: 10.7759/cureus.55753. eCollection 2024 Mar.
Introduction Cerebral palsy (CP) characterizes a range of permanent, nonprogressive symptoms of postural and motor dysfunction caused by an insult to the developing central nervous system in a fetus or an infant. CP manifests early in life, often within the first two to three years of age. CP is associated with poor growth, that is the deviation from the normal growth parameters. The prevalence of CP ranges from 2.0 to 3.5 per 1000 live births in high-income countries which is comparable to the estimates from low-income countries. Antenatal and perinatal insults are among the most commonly reported causes of CP; however, a large number of cases do not have an identifiable etiology of CP. The current study aims to examine the relationship between malnutrition and gross motor function in children with CP. Materials and Methods This study was conducted at the Department of Pediatrics and Neonatology, Nehru Hospital, Baba Raghav Das (BRD) Medical College, Gorakhpur (UP) over a period of one year (August 2020 to July 2021) after obtaining ethical clearance from the College Research Council. Children of age 1-15 years with CP attending the pediatric outpatient and inpatient departments were enrolled as the study participants after obtaining informed consent from a legal guardian. Assessment of motor function was done using the gross motor function classification system (GMFCS). Associations of malnutrition across levels of gross motor function were tested using Chi-square or Fisher's exact test whichever was applicable. Statistical significance was set at p < 0.05 as significant. Data was analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). Result We analyzed 110 children with a diagnosis of CP (median age 6.5 years, interquartile range (IQR) 4.4-9.0 years). The majority (65/110; 59%) of the patients were male, and 68 (61.8%) delivered at term gestation. The most common presenting symptom among children with CP was seizures (79/110; 72.3%), the second most common being delayed milestones among 73 (66.8%), followed by difficulty in breathing among 63 (57.5%). The association between the anthropometric index of participants and GMFCS was found to be highly significant. Conclusion Most CP patients were facing gross motor disturbances. Spastic type of CP was most frequent, and more than half of the patients experienced feeding difficulty. A statistically significant association was found between gross motor functioning and the prevalence of malnutrition and stunting.
引言
脑性瘫痪（CP）的特征是一系列永久性、非进行性的姿势和运动功能障碍症状，由胎儿或婴儿发育中的中枢神经系统受损引起。CP在生命早期出现，通常在1至3岁之间。CP与生长发育不良有关，即偏离正常生长参数。在高收入国家，CP的患病率为每1000例活产中有2.0至3.5例，这与低收入国家的估计数相当。产前和围产期损伤是CP最常见的报告病因；然而，大量病例没有可识别的CP病因。本研究旨在探讨CP患儿营养不良与粗大运动功能之间的关系。
材料与方法
本研究在印度北方邦戈勒克布尔市巴巴拉格哈夫达斯（BRD）医学院尼赫鲁医院儿科和新生儿科进行，为期一年（2020年8月至2021年7月），并获得了学院研究委员会的伦理批准。年龄在1至15岁的CP患儿在获得法定监护人的知情同意后，作为研究参与者被纳入儿科门诊和住院部。使用粗大运动功能分类系统（GMFCS）对运动功能进行评估。使用卡方检验或Fisher精确检验（适用者）测试不同粗大运动功能水平下营养不良的相关性。统计学显著性设定为p < 0.05为显著。使用IBM SPSS Statistics for Windows，版本2l（2012年发布；IBM公司，美国纽约州阿蒙克）对数据进行分析。
结果
我们分析了110例诊断为CP的儿童（中位年龄6.5岁，四分位间距（IQR）4.4 - 9.0岁）。大多数患者（65/110；59%）为男性，68例（61.8%）足月分娩。CP患儿最常见的症状是癫痫发作（79/110；72.3%），其次是发育迟缓7共73例（66.8%），呼吸困难63例（57.5%）。研究发现参与者的人体测量指标与GMFCS之间的关联具有高度显著性。
结论
大多数CP患者面临粗大运动障碍。痉挛型CP最为常见，超过一半的患者存在喂养困难。在粗大运动功能与营养不良和发育迟缓患病率之间发现了统计学显著关联。
