Analysis Of The Risk Factors On Children With Cerebral Palsy In Henan Province

Background and ObjectiveThe western region of Australia established the most primitive cerebral palsyRegistration Office in the mid-1970s. The Registration Office played increasinglyprominent role in the management of children with cerebral palsy as the graduallyimprovement of itself. Many areas followed to establish similar regulatory agencies tomonitor cerebral palsy. Researchers understand changes in the incidence of cerebralpalsy, find the cause of cerebral palsy and find effective methods of prevention andmanagement of children with cerebral palsy by using these datas. As a populous zone,Henan province has not established monitoring agency for cerebral palsy, and lackedthe related information of cerebral palsy. Therefore, we use the method of stratifiedcluster random sampling to do an epidemiological investigation of0-6years oldchildren with cerebral palsy in Henan province. Children with CP brought a greatburden to the family and community, and currently the treatment effect for cerebralpalsy is not satisfactory, these indicate that identifing the risk factors of cerebral palsy,reducing exposure will play an significant role in controlling the population of CP. Inthis paper, we apply population-based case-control study to investigate risk factors ofchildren with CP occurred in Henan Province. The results will help to carry out themother health guidance during pregnancy, early screen of high-risk children, timelyintervention, and achieve the purpose of prenatal and postnatal care and reducing disabled children. In addition, it aimed at offering data for government departmentsdeveloping rehabilitation policy and improving the social welfare of children.Data and MethodsA case-control study by1:4matched was carried out. The cases of children withcerebral palsy were from0-6years old children’s epidemiological investigationbetween September2011and September2012in Henan Province. The control matchwas selected four healthy children (requirement: Home address located near theresidence of children in case group, same sex, age within3months). Householdsurvey was in the form of a questionnaire survey which conducted by the parents tofill children’s development experience. Questionnaire were collected by the qualitycontrol staff, to identify problems and timely confirm, which were to ensure theintegrity and authenticity of each questionnaire. Epidata3.2was adopted to establish adatabase, double person to input data. The SAS9.1.3software was used to analyze thedata. Statistical analysis of single factor conditional Logistic regressions wereperformed to screened the risk factors of CP. The main factors were analysis bymultivariate conditional Logistic regressions.Results1. Family factors: the age of mother during pregnancy≥30-year-old, whosebaby suffer from CP risk than pregnant mothers aged25to30years old is6.029fold,paternal age≥30years old the risk is5.263, and the father or mother who acceptedhigh school or higher education the risk is0.369,0.254, the annual per-capitaincome>$10,000which family risk of CP is0.260, father or mother exposure toharmful physical and chemical factors and having family history are also associatedwith the occurrence of CP;2. Pregnancy factors: passive smoking during pregnancy>2times per weekwhose baby CP risk is passive smoking during pregnancy≤2times per week by3.518times. Pregnancy in newly decorated rooms, pregnancy illness, medication, mediumor poor nutritional status, vaginal bleeding in early pregnancy, adverse pregnancy history are associated with CP, the risk is also on the increase with gravidity parityincreases;3. Intrapartum factors: the birth place of the county hospital, gestational age<37weeks, cesarean section, unusual circumstances in birth process and asphyxia afterbirth are statistically significant with the incidence of CP;4. Neonatal factors: neonatal disease of risk is without disease in the neonatalperiod of CP by68times, including neonatal hypoxic-ischemic encephalopathy (HIE)is a major risk factor;5. Multivariate analysis show that the age of mother during pregnancy≥30-year-old, pregnancy in newly decorated rooms, pregnancy illness, menstrualdisorders, pregnancy times≥3, adverse pregnancy history, premature birth(<37weeks) and neonatal disease are risk factors of cerebral palsy, the annual per-capitaincome>$10,000is the protective factor.Conclusions1. All factors in family factors, pregnancy factors, intrapartum factors andneonatal factors were be analyzed, ultimately nine factors are associated with thepresence of the incidence of cerebral palsy;2. The age of mother during pregnancy≥30-year-old, pregnancy in newlydecorated rooms, pregnancy illness, menstrual disorders, pregnancy times≥3,adverse pregnancy history, premature birth(<37weeks) and neonatal disease are riskfactors of cerebral palsy;3. The annual per-capita income>$10,000is the protective factor, somemeasures should be to effectively prevent and reduce the incidence of cerebral palsy,such as targeting pregnancy check-ups and health guidance for high-risk pregnantwomen, active screening and early intervention in high-risk children, spreadingknowledge of cerebral palsy.