Implication of orogastric disorders, functional motor skills and feeding in the growth of children and adolescents with cerebral palsy

Abstract

Introduction: Cerebral palsy (CP) is the most common pediatric disability and can affect growth.

Objective: To compare growth according to nutritional status related to oro-gastric disorders and functional classifications (GMFCS and EDACS) in children with CP aged 2 to 18 years.

Materials and methods: Observational, cross-sectional study. Children with CP from Argentina were included. Nutritional status was assessed with WHO Anthro Plus software, 2007. Normal data were presented as means and SD, non-normal data as medians and ranges. Discrete data were presented as percentages with [95% CI]. Mann-Whitney and t tests were used to analyze variable associations. Multiple linear regression models (MLR) were performed to determine the effect of significant clinical variables on anthropometric results. Variables with p<0.05 in the bivariate analysis were included in MLR models.

Results: 202 records were collected. 110 were males (55% [47.8;61.9]). The mean age was 7.34 years ±4.56. A statistically significant difference was observed with greater compromise in P/E, T/E and BMI/E Z-scores in children with orogastric problems and severe GMFCS and EDACS compromises. When adjusting the variables in a binary regression model for P/E, at more severe levels of EDACS there were 8.77 times (p=0.001 [95%CI2.5;30.5]) and 3.36 times (p=0.03 [95%CI 1.0;10.5] more chances of underweight for GMFCS (IV-V). When adjusting variables in relation to T/E, those with GMFCS and EDACS levels IV/V had 2.63 (p=0.04 [CI95%1.0;6.8] and 7.93 (p=<0.001 CI95%2.8;21.9] times more chances of having short stature.

Conclusion: Those who present oro-gastric disorders and severe levels in functional classifications are more likely to present low height and low weight.