Study On Epidemiology Of Children With Cerebral Palsy In Hangzhou Region

Objective Conduct the epidemiological study of children with cerebral palsy in Hangzhou region,collect and summarize epidemiological etiology related data in cerebral with palsy children,analyze and summarize its etiology and epidemiology related risk factors in Hangzhou region,which can help prevent the occurrence of cerebral palsy children,and promote good prenatal,postnatal care,better upbringing.The results will provide further clinical data support for preventing and controlling the early onset of cerebral palsy,improving prophylaxis and treatment.In addition,which will also provide the scientific policy basis for the government to help and cure children with cerebral palsy in Hangzhou region.This study has important practical significance in the future.Methods This study randomly selected 300 cases of children at 0-6 years old(born January 01,2011,to December 31,2016)diagnosed in Hangzhou,zhejiang province..The epidemiological investigation of children with cerebral palsy was carried out by means of medical institution investigation and on-site evaluation of follow-up survey.In comparison with 1:1 matched cases,a healthy child with same gender,age and home address was selected as the control.(Requirements:gender identity,age difference less than 3 months,home address in the vicinity of cerebral palsy children's address.)The survey was carried out in the form of questionnaires,and all the respondents filled out the child development questionnaire.The collected questionnaires are reviewed by the quality controller,and the problems are confirmed in time to ensure the integrity and authenticity of each questionnaire.The database was established by using Excel software,and the data is repeatedly recorded by double machine.The final data was processed by SPSS20.0 software,and analysed by chi-squared test,single factor/multi-factor conditional Logistic regression models.Results ? There was no statistically significant difference between gender,nationality,age and cerebral palsy.? Family factors:Maternal age(age 30)is associated with the onset of cerebral palsy.The educational level of father is the risk factor for cerebral palsy.The risk value of cerebral palsy is 2.341 among children whose fathers graduated from junior high school and below,which is 2.528 times higher than whose fathers graduated from high school and above.? Prepartum factors:Disease,pregnancy diseases,pregnancy medication,parents drinking,smoking and passive smoking during pregnancy,as well as the number of abortion,father's long-term exposure to hazardous chemicals,living in newly renovated rooms,vaginal bleeding in early pregnancy is closely related to occurrence of cerebral palsy? Intrapartum factors:Twins have the highest risk(OR 5.206,95%confidence interval1 959-13.836).The smaller the gestational age was,the higher the risk of cerebral palsy.The risk of cerebral palsy in preterm infants less than 28 weeks pregnant is 52.64 times that of full-term infants,and the risk of cerebral palsy in preterm infants 28-36 weeks is 24.44 times that of full-term infants.The risk value of cerebral palsy was higher in obstetric forceps(OR 10.216,95%confidence interval1.279-81.594).Difficult labor during labor(P<0.05,OR value 2.766,95%confidence interval1.392-5.496),asphyxia(P<0.05,OR value 4.04,95%confidence interval2.031-8.042)are all related factors of cerebral palsy.Birth weight is very important in the development of cerebral palsy(P<0.05),the incidence of cerebral palsy was higher in children with low birth weight(<2500g)(OR1.447,95%confidence interval0.460-4.550).The level of childbirth hospital is a protective factor.? Postpartum factors:intracranial hemorrhage,hypoglycemia,convulsion,intracranial infection and intrauterine infection were all statistically significant,and all P values were<0.05.?Multiple factors regression analysis results showed that pregnancy disease,premature delivery,pregnancy live in new homes,miscarriage,abortion twice,<the 28th week of gestation,28-36 weeks of gestation,asphyxia,HIE and intracranial hemorrhage,hypoglycemia,labor were the risk factors of CP.?Within spastic type cerebral palsy type,the occurrence of quadriparesis rate was the highest,followed by spastic quadriplegia(55.3%),spastic diplegia(25%),spastic hemiplegia(10%),involuntary exercise(2.3%),Ataxia(2.3%),mixed(5.0%);?Cerebral palsy comorbidities include:mental retardation,epilepsy,speech impairment,hearing loss,periventricular leukomalacia,cerebral dysplasia,malnutrition,microcephaly,cerebral softening lesion,corpus callosum dysplasia,etc.Among them,53%of patients with cerebral palsy had cerebral palsy with one comorbidity,34.7%with 2 cases,and 12.3%with 3 or more comorbidities.Conclusion 1.The main clinical types of children cerebral palsy in Hangzhou region are spastic quadriplegia,followed by spastic dipolalia,spastic hemiplegia,involuntary exercise,ataxia,mixed type.2.The etiology risk factors of children cerebral palsy in Hangzhou region include maternal pregnancy disease,low birth weight,new occupancy during pregnancy,abortion,premature delivery,dystocia,labor apnea,intracranial hemorrhage.3.The comorbidity of children cerebral palsy in Hangzhou region have various types,mainly includes mental retardation,epilepsy,speech impairment,hearing loss,periventricular leukomalacia,cerebral dysplasia,malnutrition,microcephaly,cerebral softening lesion,corpus callosum dysplasia,.the comorbidity rate is as high as 100%.