DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20221610
Published: 2022-06-23

Cerebral palsy specific growth charts for Indian children: need of the hour

Govind Choudhary, Nusrat Rahim Inamdar, Anupama Mauskar

Abstract


Background: Children with cerebral palsy (CP) are generally undernourished and growth retarded. The nutritional assessment and anthropometry have important role in management of these problems. Reference growth curves for Indian children with CP may be helpful to clinicians and beneficial to children for better assessment of nutritional status and to monitor growth. This study was conducted to compare the anthropometric inferences derived from specific growth curves for CP developed by centers for disease control (CDC) with that of using WHO and IAP growth curves.

Methods: Cross sectional observational study conducted on 40 children with CP aged 2 to 12 year. Through universal sampling. Anthropometric variables measured and plotted on age and gender specific growth curves for cerebral palsy and on WHO / IAP growth curves. Nutritional assessments on these growth curves are then compared.

Results: Number of underweight children were more on WHO/IAP growth curves 52.5% (n=21) compared to CP specific growth curves 20% (n=8) (p=0.002) similarly, number of stunted children were more on WHO/IAP growth curves (40% versus 0%) compared to CP specific growth curves (p=0.0001) both being statistically significant. No significant difference was seen on comparing BMI (p=0.067).

Conclusions: Significant difference in nutritional status is observed when anthropometric variables are compared on two curves (CP specific versus WHO/IAP curves). Applying WHO/IAP growth curves, to assess the growth of children with cerebral palsy may not be appropriate and may have fallacies with interpretations of growth and nutritional status. Apart from nutrition, functional status and co morbidities also play a vital role in deciding nutritional status. Disease specific or standardized growth charts for Indian children with CP may play an important role in early diagnosis and management of growth faltering.


Keywords


Cerebral palsy, Anthropometry, Growth curves, Nutrition, GMFCS

Full Text:

PDF

References


Calis EA, Veugelers R, Sheppard JJ, Tibboel D, Evenhuis HM, Penning C. Dysphagia in children with severe generalized cerebral palsy and intellectual disability. Dev Med Child Neurol. 2008;50:625-30.

Bell KL, Boyd RN, Tweedy SM, Weir KA, Stevenson RD, Davies PS. A prospective, longitudinal study of growth, nutrition and sedentary behaviour in young children with cerebral palsy. BMC Public Health. 2010;10:179.

Sullivan PB. Gastrointestinal disorders in children with neurodevelopmental disabilities Disabil Res Rev 2008;14:128-36.

Brooks J, Day S, Shavelle R, Strauss D. Low weight, morbidity, and mortality in children with cerebral palsy: new clinical growth charts. Pediatrics. 2011;128:299-307.

Day SM, Strauss DJ, Vachon PJ, Rosenbloom L, Shavelle RM, Wu Yw. Growth patterns in a population of children and adolescent with cerebral palsy. Dev Med Child Neurol. 2007;49:167-71

Cronk C, Crocker AC, Pueschel SM. Growth charts for children with Down Syndrome: 1 month to 18 years of age. Pediatrics. 1988;81:102-10.

Rongen-Westerlaken C, Corel L, van den BJ. Reference values for height, height velocity and weight in Turner’s syndrome. Swedish Study Group for GH Treatment. Acta Paediatr. 1997;86:937-42.

Myrelid A, Gustafsson J, Ollars B. Growth charts for Down’s syndrome from birth to 18 years of age. Arch Dis Child. 2002;87:97-103.

Styles ME, Cole TJ, Dennis J. New cross-sectional stature, weight, and head circumference references for Down’s syndrome in the UK and Republic of Ireland. Arch Dis Child. 2002;87:104-8.

Stallings VA, Charney EB, Davies JC. Nutrition-related growth failure of children with quadriplegic cerebral palsy. Dev Med Child Neurol. 1993;35:126-38.

Caram AL, Morcillo AM, Costa-Pinto EA. Nutritional statusof children with cerebral palsy in a Brazilian tertiarycare teaching hospital. Dev Med Child Neurol. 2008;50:956.

Kuperminc MN, Stevenson RD. Growth and nutrition disorders in children with cerebral palsy. Dev Disabil Res Rev. 2008;14:137-46.

Stevenson RD, Conaway M, Chumlea WC. Growth and health in children with moderate-to-severe cerebral palsy. Pediatrics. 2006;118:1010-8.

Johnston MV. Nelson textbook of pediatrics, Encephalopathies: Cerebral Palsy. 21st edition. Elsevier. 2020;3168-73.

Araújo LA, Silva LR. Anthropometric assessment of patients with cerebral palsy: which curves are more appropriate? J Pediatr (Rio J). 2013;89:307.

Wright CM, Reynolds L, Ingram E, Cole TJ, Brooks J. Dev Med Child Neurol. 2017;59(9):933-8.