A Survey Of Cerebral Palsy In Rural Areas Of Zaozhuang1-6Years Old Children

Cerebral palsy (CP), the most common disability disorders during pediatricperiod, refers to the progressive brain damage and the syndrome caused bydevelopmental defect, as manifested in dyskinesia and abnormal posture.World Health Organization reports revealed that the incidences of childrencerebral palsy from1‰to5‰. However, there weren’t any reports about theincidences nationwide at home except a sample survey of1-6yearsold childrenaround six provinces (autonomous regions) with an incidence of1.92‰in2001.Kinds of risk factors can give rise to CP, and etiologies are full of diversities andcomplexities. Abnormal labor, dystocia and neonatal asphyxia which can causehypoxia are described as main reason of CP by Little140year ago and this resultswere widely accepted for a long time. With the further development of study,prenatal factors are proposed as the main reason instead of intrapartum factors.Objective: To provide the reference for prevention and control measures ofchildren cerebral palsy for relevant departments through the description of theprevalence and the analysis of risk factors in1-6year old children in rural areas ofZaozhuang.Methods: A randomized cluster sampling survey method was used to make aepidemiological survey including all of the1-6year old children of the surveyed area.The diagnosed children with cerebral palsy as the case group, and according tothe proportion of1:4, every diagnosed children with cerebral palsy match fournormal children constitute a case-control to analysis the risk factors of the children with cerebral palsy.Epidata3.1statistical software was applicated to establish the database andSPSS13.0statistics software was carried on to do the statistical treatment.Results:1. A total of20077people of1-6year old children were registrated, thenumber of the diagnosed children with cerebral palsy is36, and the morbidity is1.79‰. The morbidity for the age group of5-6years old (not include6years old) isthe highest, it is2.07‰。Among these36cases, there were24male, and12female,the morbidity of male is more than female.2. After the discovery of abnormal of the36cases,97.2%of them selectedthe local hospital to make diagnosis and give treatment, and94.4%of then selectedthe maternal and child health hospital to make diagnosis and give treatment.72.2%of the cases choose the rehabilitation way of a combination of kinds of modes.94.4%of the local hospital couldn’t make orthopaedic apparatus and auxiliary tools;61.1%of the children with cerebral palsy was registed but the follow-up onlyaccount for17.1%, and2.8%establish monitoring files. What’s more, the cost oftreatment of97.2%of the case can be partly reimbursed, while47.2%of the casescan get the special financial aid from the government.3. Among the36children with cerebral palsy, there were24cases ofconvulsion type, accounting for66.7%; followed by6cases of low muscle tensiontype, accounting for16.7%; three cases of Ataxia type, accounting for8.3%; twocases of Involuntary sport, accounting for5.6%; one case of Mixed type, accountingfor2.8%.4. Single factor analysis showed the statistically significant factors respectivelyare, the age of father(>30years old)（OR=3.125）, the annual per capita income offamilies （≤10thousand）（OR=2.802）, the mental illness of family history（OR=12.000）, the mother had cold during pregnancy（OR=11.989）, the frequencyof passive smoking of pregnant women (≥2times)（OR=8.413）, the frequency of pregnancy（OR=4.206）, the frequency of abortion (≥1times（)OR=6.122）,the historyof premature delivery（OR=7.358）, labor extension (＞24h（)OR=12.000）.Amongthe36cases, the number of neonatal asphyxia is9, the proportion is25%.Theanalysis of possible risk factors through multifactor condition logistic regrssionmodel, there are4factors associated with cerebral palsy, they are neonatal asphyxia,the mother had cold during pregnancy, the frequency of passive smoking of pregnantwomen (≥2times), the frequency of abortion (≥1times), the history of prematuredelivery.conclusion:1. The morbidity of cerebral palsy in rural areas of Zaozhuang1-6years oldchildren is close to the morbidity of cerebral palsy in six provinces of our country1-6years old children, the most children with cerebral palsy is male.2. The most of1-6years old children with cerebral palsy in rural areas ofZaozhuang selected the local hospital, especially maternal and child care servicecenters, to make a diagnosis and give treatment, and a majority of them choose therehabilitation way of a combination of kinds of modes. A majority of children withcerebral palsy was registed but the follow-up only is small number, What’s more, thecost of treatment of most of children can be partly reimbursed.3. Among the1-6years old children with cerebral palsy in rural areas ofZaozhuang, largely is convulsion type, in the others, followed by low muscle tensiontype, Ataxia type, Involuntary sport, Mixed type.4. The main risk factors of the1-6years old children with cerebral palsy inrural areas of Zaozhuang are neonatal asphyxia, the mother had cold duringpregnancy, the frequency of passive smoking of pregnant women (≥2times), thefrequency of abortion (≥1times), the history of premature delivery.