Abstract
Background: Cerebral palsy (CP) is a motor disability that originates in the early childhood; it is a group of permanent disorders that affect movement and posture, that typically result from brain insult in early childhood. Knowledge of the antecedents responsible for the development of CP is requisite for the champions of primary prevention as well as for management of children with such affliction especially in the developing nations. This cross-sectional study was carried out at a tertiary care hospital in Karachi, Pakistan where, healthcare services such as prenatal, perinatal, and postnatal care might affect CP outcomes.Aim: The intended outcome of this research was to define predisposing factors related to cerebral palsy among paediatric patients in a tertiary care institution.
Method: About the study, a descriptive cross-sectional research design was adopted with the study site situated at the Department of Neurology, Dow University of Health Sciences, Karachi. A quantitative cross-sectional study which involved 91 children, with a confirmed diagnosis of CP, ranging from 2 to 8 years. The participants were chosen through the method of non-probability convenience sampling. Parents were interviewed using closed-ended questions, and the child’s physical condition was assessed using a neurological examination with emphasis on predisposing factors such as P-I-H, perinatal factors such as birth asphyxia, and postnatal factors such as CNS infections. Data analysis was done Statistical Package for the Social Sciences (SPSS) version 24, Descriptive Statistical techniques was used for data presentation.
Results: PIH was reported as the leading prenatal condition with prevalence of 31 percent among the immediate post-partum clients. 9 % of the children and that was closely linked to mixed-type CP. Poor birth asphyxia assumed the largest perinatal factor and accounted for CP in 35 percent. However, it affects only 2% of the cases, and specific type is spastic diplegia. As expected, most of postnatal factors in this study were infection related and CNS infections were the most common, Affecting 39. 6% of the children and were significantly related to the types of spasticity including spastic diplegia, hemiplegia, and quadriplegia. Another parameter which was identified to have a connection with the increased cases of CP was spontaneous vaginal delivery and low parental education.
Conclusion: This work appreciates the impact of antepartum, intrapartum and neonatal factors in the causation of CP as explained by PIH, birth asphyxia and CNS infections. Thus, there is a need to also increase awareness of prenatal healthcare, attendants during childbirth, and preventable infections in order to reduce cases of CP. There is a need to conduct future studies to understand the development of the specified factors to result in CP and to establish the efficacy of early-intervention initiatives in the long-term.
Keywords: Cerebral palsy, predisposing factors, pregnancy-induced hypertension, birth asphyxia, CNS infections, paediatric neurology, Karachi.