Risk factors for intellectual disability in children with spastic cerebral palsy

David Cummins; Claire Kerr; Karen McConnell; Oliver Perra

doi:10.1136/archdischild-2020-320441

Risk factors for intellectual disability in children with spastic cerebral palsy

David Cummins, Claire Kerr, Karen McConnell, Oliver Perra

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Abstract

Background Cerebral palsy (CP) is a non-progressive disorder of posture and movement caused by prenatal or perinatal lesions of the brain. Children with CP are also at increased risk of other disabilities, for example, intellectual disability. Previous studies suggest the risk of intellectual disability varies in complex ways according to the type of motor impairment and perinatal factors such as gestational age.

Objective To determine the patterns of risk of intellectual disability in children with spastic CP.

Design Cross-sectional, population-based study using the Northern Ireland Cerebral Palsy Register.

Participants Persons born in 1981-2008 with congenital bilateral or unilateral spastic CP (N=1452).

Outcome measure The outcome measure was severe intellectual disability (IQ <50), as reported by clinicians known to the child. Data pertaining to CP subtype, sex, gestational age, birth weight and functional level were included in analyses.

Results Severe intellectual disability was significantly more prevalent in children with bilateral spastic CP (BSCP) compared with children with unilateral spastic CP (χ² (2)=162.60, p<0.001). Compared with very preterm infants with BSCP, the risk of intellectual disability increased in moderately preterm (OR=3.97, 95% CI 1.04 to 15.23) and at-term (OR=2.51, 95% CI 1.16 to 5.44) children with BSCP.

Conclusions Children with BSCP are at increased risk of intellectual disability, with those born at term at the highest risk. The findings highlight the importance of early screening, particularly for children with BSCP born at term.

Original language	English
Article number	320441
Pages (from-to)	975-980
Number of pages	6
Journal	Archives of disease in childhood
Volume	106
Issue number	10
Early online date	16 Mar 2021
DOIs	https://doi.org/10.1136/archdischild-2020-320441
Publication status	Published (in print/issue) - 1 Oct 2021

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Funding Information:
Funding The Northern Ireland Cerebral Palsy Register is funded by the Public Health Agency, Northern Ireland.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021.

Keywords

cerebral palsy
intellectual disability
register
Cross-Sectional Studies
Humans
Risk Factors
Child, Preschool
Infant
Male
Gestational Age
Intellectual Disability/epidemiology
Birth Weight
Cerebral Palsy/classification
Premature Birth/epidemiology
Female
Infant, Small for Gestational Age
Registries
Northern Ireland/epidemiology
Infant, Newborn
Term Birth
epidemiology
neurology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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archdischild-2020-320441.fullFinal published version, 488 KBLicence: CC BY-NC

Cite this

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title = "Risk factors for intellectual disability in children with spastic cerebral palsy",

abstract = "Background Cerebral palsy (CP) is a non-progressive disorder of posture and movement caused by prenatal or perinatal lesions of the brain. Children with CP are also at increased risk of other disabilities, for example, intellectual disability. Previous studies suggest the risk of intellectual disability varies in complex ways according to the type of motor impairment and perinatal factors such as gestational age. Objective To determine the patterns of risk of intellectual disability in children with spastic CP. Design Cross-sectional, population-based study using the Northern Ireland Cerebral Palsy Register. Participants Persons born in 1981-2008 with congenital bilateral or unilateral spastic CP (N=1452). Outcome measure The outcome measure was severe intellectual disability (IQ <50), as reported by clinicians known to the child. Data pertaining to CP subtype, sex, gestational age, birth weight and functional level were included in analyses. Results Severe intellectual disability was significantly more prevalent in children with bilateral spastic CP (BSCP) compared with children with unilateral spastic CP (χ² (2)=162.60, p<0.001). Compared with very preterm infants with BSCP, the risk of intellectual disability increased in moderately preterm (OR=3.97, 95% CI 1.04 to 15.23) and at-term (OR=2.51, 95% CI 1.16 to 5.44) children with BSCP. Conclusions Children with BSCP are at increased risk of intellectual disability, with those born at term at the highest risk. The findings highlight the importance of early screening, particularly for children with BSCP born at term.",

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author = "David Cummins and Claire Kerr and Karen McConnell and Oliver Perra",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Funding Information: Funding The Northern Ireland Cerebral Palsy Register is funded by the Public Health Agency, Northern Ireland. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2021.",

year = "2021",

month = oct,

day = "1",

doi = "10.1136/archdischild-2020-320441",

language = "English",

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AU - Cummins, David

AU - Kerr, Claire

AU - McConnell, Karen

AU - Perra, Oliver

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Funding Information: Funding The Northern Ireland Cerebral Palsy Register is funded by the Public Health Agency, Northern Ireland. Publisher Copyright: © Author(s) (or their employer(s)) 2021.

PY - 2021/10/1

Y1 - 2021/10/1

N2 - Background Cerebral palsy (CP) is a non-progressive disorder of posture and movement caused by prenatal or perinatal lesions of the brain. Children with CP are also at increased risk of other disabilities, for example, intellectual disability. Previous studies suggest the risk of intellectual disability varies in complex ways according to the type of motor impairment and perinatal factors such as gestational age. Objective To determine the patterns of risk of intellectual disability in children with spastic CP. Design Cross-sectional, population-based study using the Northern Ireland Cerebral Palsy Register. Participants Persons born in 1981-2008 with congenital bilateral or unilateral spastic CP (N=1452). Outcome measure The outcome measure was severe intellectual disability (IQ <50), as reported by clinicians known to the child. Data pertaining to CP subtype, sex, gestational age, birth weight and functional level were included in analyses. Results Severe intellectual disability was significantly more prevalent in children with bilateral spastic CP (BSCP) compared with children with unilateral spastic CP (χ² (2)=162.60, p<0.001). Compared with very preterm infants with BSCP, the risk of intellectual disability increased in moderately preterm (OR=3.97, 95% CI 1.04 to 15.23) and at-term (OR=2.51, 95% CI 1.16 to 5.44) children with BSCP. Conclusions Children with BSCP are at increased risk of intellectual disability, with those born at term at the highest risk. The findings highlight the importance of early screening, particularly for children with BSCP born at term.

AB - Background Cerebral palsy (CP) is a non-progressive disorder of posture and movement caused by prenatal or perinatal lesions of the brain. Children with CP are also at increased risk of other disabilities, for example, intellectual disability. Previous studies suggest the risk of intellectual disability varies in complex ways according to the type of motor impairment and perinatal factors such as gestational age. Objective To determine the patterns of risk of intellectual disability in children with spastic CP. Design Cross-sectional, population-based study using the Northern Ireland Cerebral Palsy Register. Participants Persons born in 1981-2008 with congenital bilateral or unilateral spastic CP (N=1452). Outcome measure The outcome measure was severe intellectual disability (IQ <50), as reported by clinicians known to the child. Data pertaining to CP subtype, sex, gestational age, birth weight and functional level were included in analyses. Results Severe intellectual disability was significantly more prevalent in children with bilateral spastic CP (BSCP) compared with children with unilateral spastic CP (χ² (2)=162.60, p<0.001). Compared with very preterm infants with BSCP, the risk of intellectual disability increased in moderately preterm (OR=3.97, 95% CI 1.04 to 15.23) and at-term (OR=2.51, 95% CI 1.16 to 5.44) children with BSCP. Conclusions Children with BSCP are at increased risk of intellectual disability, with those born at term at the highest risk. The findings highlight the importance of early screening, particularly for children with BSCP born at term.

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KW - epidemiology

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Risk factors for intellectual disability in children with spastic cerebral palsy

Abstract

Bibliographical note

Keywords

UN SDGs

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