Relationship between perinatal complications, associated conditions, early detection and care, and motor impairment in people with cerebral palsy in Colombia.

Abstract

Introduction: Severe cerebral palsy (CP) (GMFCS IV and V) is the most common presentation in low- and middle-income countries with available data and has the highest comorbidity rates. Early detection is essential for timely intervention.

Objective: Analyze the relationship between perinatal complications, associated conditions, early detection, and care with PC GMFCS IV and V.

Materials and Methods: Observational, descriptive, cross-sectional study in people with CP at a rehabilitation center in Medellín, Colombia. Normal continuous variables were described as means with their SDs, and discrete variables were described as percentages with 95% CI. Fisher's exact test was used to compare differences between groups.

Results: Data were collected from 154 PC records.  The median age was 9.0 years (IQR 5.0-14.7). Of the total sample, 96 (62.7% [54.5-70.3]) had severe motor impairment (GMFCS IV-V). 96 (62.3% [54.1-69.9]) had complications during delivery and 76 (49.3% [41.1-57.4]) had sucking difficulties in the first month of life. Seventy-seven (50% [41.8-58.1]) were diagnosed in the first year, and 74 (48% [39.8-56.1]) began rehabilitation in the same period. This study reveals a statistically significant association between motor impairment and variables such as swallowing difficulties in the first month of life (p=0.004), detection (p=0.033), and early intervention (p=0.038) and associated conditions (intellectual disability (p=0.000), epilepsy (p=0.016), and dysphagia (p=0.000)). These variables were more prevalent in individuals with severe motor impairment.  No significant differences were found with variables related to complications during delivery.

Conclusion: Children with greater motor impairment have greater difficulty sucking in the first month of life, are diagnosed and receive rehabilitation early (before 1 year of age), and are more likely to have intellectual disability, epilepsy, and dysphagia.