Analysis Of The Risk Factors In Uighur Children With Cerebral Palsy In Xinjiang

Background and Objective Cerebral palsy(CP)is the most common cause of childhood physical disability.The global morbidity of CP in recent more than 50 years is almost at 2/1000 to 3/1000.The brain of newborn suffers non-progressive damage in antenatal,intrapartum or postpartum period,leading to a syndrome complex with permanent abnormal body posture and dyskinesia.The specific pathogenesis of CP is very complicated and varied,and the pathogenic mechanism of CP is still not clear now.The generally accepted risk factors of CP mainly are premature birth,intrauterine infection,neonatal asphyxia,fetal growth restriction,but there also many scholars think that heritable variation is closely related to CP.Many domestic regions have established regulatory agencies to monitor CP.We can better understand the morbidity variation and the relative risk factors of CP by collecting and analyzing the data relative to CP,then provide significant references to the prevention,intervention and treatment of CP.Xin Jiang region has not established monitoring agency for CP,and lacked the related information of CP.In resent years,our hospital has treated many CP children coming from different regions of Xin Jiang,most of them are Uighur children.To fill up the children CP information in Xin Jiang region,we carry out epidemiological investigation and case control study of CP on the Uighur children(0-6 years old)in Xinjiang autonomous region.We explore the risk factors of children CP in Xinjiang,which will be beneficial to carry out the mother health guidance during pregnancy,early screen of high-risk children,timely intervention,and reducing the incidence of CP in children.Data and Methods286 Uighur children(0-6 years old)with CP were collected as the case group from Xinjiang autonomous region people's hospital during Jan.2013 to Jun.2015.Using 1:2case-contro,the control group enrolled 572 Uighur healthy children,all from the Child Health Division in the same hospital,with age difference no more than 6 months and roughly the same gender.Investigators fill in the questionnaire by asking the family members and looking up the medical records.The questionnaire mainly contain antenatal factors(mother gestation age,intermarriage,family history of encephalopathy,multiple pregnancy,pregnant infection,living in new house during pregnancy,pregnancy-induced hypertension,mother active and passive smoking,negative reproductive history),intrapartum factors(gestational age,dystocia,fetal head extraction or forceps delivery,cesarean section,fetal distress,low birth weight,neonatal asphyxia),postpartum factors(neonatal convulsions,neonatal intracranial hemorrhage,neonatal aspiration pneumonia,neonatal severe jaundice and newborn hypoxia ischemia).The data was analyzed by single factor and multiple factors conditional Logistic regressions in the SAS9.1.3 software,compute the OR and 95% CI,inspection level?=0.05.P<0.05 means the difference has statistical significance.Rusults1.Antenatal factors: the CP risk in family history of encephalopathy is 31.68 fold to the normal family,the CP risk for intermarriage is 15.82,the CP risk for pregnant infection is 16.68,and the CP risk for negative reproductive history is 12.35.2.Intrapartum factors: the smaller the gestational age,the higher the CP risk.The lower the birth weight,the higher the CP risk.The CP risk for neonatal asphyxia is43.57,and the CP risk for fetal distress is 25.39,besides,dystocia is also associated with the occurrence of CP.3.Postpartum factors: neonatal severe jaundice and newborn hypoxia ischemia are apparently associated with the occurrence of CP,with risk value 33.86 and 56.39 respectively.4.Multiple-factor logistic analysis showed that the risk factors of CP in Xin Jiang Uighur children mainly contain intermarriage,family history of encephalopathy, pregnant infection,negative reproductive history,gestational age<32 weeks,fetal distress,low birth weight,neonatal asphyxia,neonatal severe jaundice and newborn hypoxia ischemia.Conclusions Our results show that the CP risk factor in Uighur children is extensive,involving various antenatal,intrapartum and postpartum factors.The high risk factors contain family history of encephalopathy,neonatal asphyxia,fetal distress,neonatal severe jaundice and newborn hypoxia ischemia.That will reminder that medical workers should strengthen the prevention and intervention of each risk factor to reduce the incidence of CP in children.