Influencing factors for malnutrition in children with cerebral palsy

XU Yanhong; LI Hong; CHEN Jing; XU Jinbo; DING Hao

doi:10.11852/zgetbjzz2024-0378

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Chinese Journal of Child Health Care ›› 2024, Vol. 32 ›› Issue (11) : 1266-1270. DOI: 10.11852/zgetbjzz2024-0378

Clinical Research

Influencing factors for malnutrition in children with cerebral palsy

XU Yanhong, LI Hong, CHEN Jing, XU Jinbo, DING Hao

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Abstract

Objective To explore the influencing factors of malnutrition in children with cerebral palsy (CP), so at to provide references for its prevention and treatment. Methods A total of 80 cases of CP children who visited the Department of Rehabilitation at Anhui Provincial Children's Hospital from January to July 2021 were collected and divided into malnutrition group and control group based on the presence or absence of malnutrition. The differences between the two groups regarding gender, age, gestational age, birth weight, feeding time, Subjective Global Nutritional Assessment (SGNA), clinical classification, Gross Motor Function Classification System (GMFCS) level, serum total protein (TP), 25-hydroxyvitamin D [25-(OH)D], hemoglobin (HGB), and ferritin (FE) were compared. Spearman correlation analysis was used to analyze the correlations of TP, 25-(OH)D, HGB and FE with nutritional status. Multivariate Logistic regression analysis was conducted to identify the influencing factors of malnutrition in children with CP. Results The proportion of patients with feeding time ≥30 minutes(χ²=21.798) and abnormal SGNA assessment(χ²=45.263)in the malnutrition group was significantly higher than that in the control group, while the average values of TP, HGB and FE were significantly lower than those in the control group (t=2.739,2.674,2.155,P<0.01). Serum HGB was positively correlated with nutritional status Z-score (r_s=0.314, P<0.05) in children with CP. Multivariate Logistic regression analysis showed that GMFCS levels Ⅱ, Ⅲ,Ⅳ, and Ⅴ were risk factors for malnutrition in CP children compared to GMFCS level Ⅰ (OR=1.750, 3.667, 1.374, 2.375, P<0.05). Conclusions GMFCS levels Ⅱ, Ⅲ,Ⅳ, and Ⅴ are risk factors for the occurrence of malnutrition in children with CP. Early identification and intervention can help improve their nutritional status.

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cerebral palsy / malnutrition / gross motor function / hemoglobin

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XU Yanhong, LI Hong, CHEN Jing, XU Jinbo, DING Hao. Influencing factors for malnutrition in children with cerebral palsy[J]. Chinese Journal of Child Health Care. 2024, 32(11): 1266-1270 https://doi.org/10.11852/zgetbjzz2024-0378

References

[1] 中国康复医学会儿童康复专业委员会, 中国残疾人康复协会小儿脑性瘫痪康复专业委员会, 中国医师协会康复医师分会儿童康复专业委员会,等.中国脑性瘫痪康复指南(2022)第一章:概论[J].中华实用儿科临床杂志,2022,37(12):887-892.
Chinese Rehabilitation Medicine Association Pediatric Rehabilitation Professional Committee, Chinese Association of Rehabilitation of Disabled Children Cerebral Palsy Rehabilitation Professional Committee, Chinese Physician Association Rehabilitation Physicians Branch Pediatric Rehabilitation Professional Committee, et al. Chinese cerebral palsy rehabilitation guidelines (2022) chapter one: Introduction [J]. Chin J Prac Pediatr, 2022, 37(12): 887-892.(in Chinese)
[2] Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral palsy: Current opinions on definition, epidemiology, risk factors, classification and treatment options [J]. Neuropsych Dis Treat, 2020, 16: 1505-1518.
[3] Speyer R, Cordier R, Kim JH, et al. Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: A systematic review and meta-analyses [J]. Dev Med Child Neurol, 2019, 61(11): 1249-1258.
[4] 怀宁,童光磊,李红,等.脑性瘫痪患儿营养状况与吞咽障碍、流涎的临床关系研究[J].医学食疗与健康,2022,20(11):24-26,95.
Huai N, Tong GL, Li H, et al. Clinical study on the relationship between nutritional status of children with cerebral palsy and swallowing disorders and drooling [J]. Med Die & Hea, 2022, 20(11): 24-26,95.(in Chinese)
[5] 施磊,童光磊,李红,等.脑性瘫痪儿童喂养/吞咽困难和营养不良筛查工具的临床应用[J].中国儿童保健杂志,2022,30(9):1024-1028.
Shi L, Tong GL, Li H, et al. Clinical application of screening tools for feeding/swallowing difficulties and malnutrition in children with cerebral palsy [J]. Chin J Child Health Care, 2022, 30(9): 1024-1028.(in Chinese)
[6] 陈婧,童光磊,施磊,等.脑瘫儿童主观全面营养评估方法的临床研究 [J].中国儿童保健杂志, 2022, 30(2): 212-215.
Chen J, Tong GL, Shi L, et al. Clinical study on the subjective comprehensive nutritional assessment method for children with cerebral palsy [J]. Chin J Child Health Care, 2022, 30(2): 212-215.(in Chinese)
[7] 陈婧,童光磊.脑瘫儿童进食功能分级系统及营养不良分析[J].中国儿童保健杂志,2022,30(5): 544-547, 557.
Chen J, Tong GL. Eating function grading system and analysis of malnutrition in children with cerebral palsy [J]. Chin J Child Health Care, 2022, 30(5): 544-547,557.(in Chinese)
[8] 王军,许文静,刘碧博,等.脑瘫儿童营养与免疫因子检测及个体化营养干预效果研究[J].中国儿童保健杂志, 2021, 29(5): 484-487,491.
Wang J, Xu WJ, Liu BB, et al. Study on detection of nutrition and immune factors in children with cerebral palsy and individualized nutritional intervention [J]. Chin J Child Health Care, 2021, 29(5): 484-487,491.(in Chinese)
[9] 中国康复医学会儿童康复专业委员会,中国残疾人康复协会小儿脑性瘫痪康复专业委员会,《中国脑性瘫痪康复指南》编委会.中国脑性瘫痪康复指南(2015):第一部分[J].中国康复医学杂志, 2015, 30(7): 747-754.
Chinese Rehabilitation Medicine Association Pediatric Rehabilitation Professional Committee, Chinese Association of Rehabilitation of Disabled Children Cerebral Palsy Rehabilitation Professional Committee, Editorial Board of Chinese Cerebral Palsy Rehabilitation Guidelines. Chinese cerebral palsy rehabilitation guidelines (2015): Part one [J]. Chin J Rehab Med, 2015, 30(7): 747-754.(in Chinese)
[10] Becker P, Carney LN, Corkins MR, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: Indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition) [J]. Nutr Clin Purac, 2015, 30(1): 147-161.
[11] Paulson A, Vargus-Adams J. Overview of four functional classification systems commonly used in cerebral palsy [J]. Children (Basel, Switzerland), 2017, 4(4):30.
[12] Duerksen DR, Laporte M, Jeejeebhoy K. Evaluation of nutrition status using the Subjective Global Assessment: Malnutrition, cachexia, and sarcopenia [J]. Nutr Clin Practice, 2021, 36(5): 942-956.
[13] Zhao Y, Tang H, Peng T, et al. Relationship between nutritional status and severity of cerebral palsy: A multicentre cross-sectional study [J]. J Rehabil Med, 2023, 55: jrm00367.
[14] 宋捷,黄林娟,郭碧丹.学龄前营养不良儿童血清25-(OH)D3、白蛋白、铁蛋白与STAMP评分的相关性及对临床结局的预测价值[J].中国儿童保健杂志, 2024, 32(1): 39-44.
Song J, Huang LJ, Guo BD. Correlation between serum 25-(OH)D_3, albumin, ferritin and stamp score in preschool children with malnutrition and predictive value for clinical outcomes [J]. Chin J Child Health Care, 2024, 32(1): 39-44.(in Chinese)
[15] 苗慧,吴玉铃,张素芬,等.儿童铁蛋白与体格指标和神经心理发育的关系[J].中国妇幼保健,2023, 38(10): 1813-1816.
Miao H, Wu YL, Zhang SF, et al. Relationship between serum ferritin and physical development and neurodevelopment in children [J]. Chil Matl and Chil Hea, 2023, 38(10): 1813-1816.(in Chinese)
[16] 肖雨,何艳斯,朱然科,等.广州地区6～18月龄儿童血清铁蛋白水平及与神经系统发育情况的相关性研究[J].中国初级卫生保健,2020,34(8):56-59.
Xiao Y, He YS, Zhu RK, et al. Study on serum ferritin levels in children aged 6-18 months in guangzhou and its correlation with neurological development [J]. Chil Pri Health Care, 2020, 34(8): 56-59.(in Chinese)
[17] Handing EP, Small BJ, Andel R, et al. Can nutrition or inflammation moderate the age-cognition association among older adults? [J]. J Gerontol B Psychol Sci Soc Sci, 2019, 74(2): 193-201.
[18] Bastian TW, Von Hohenberg WC, Georgieff MK, et al. Chronic energy depletion due to iron deficiency impairs dendritic mitochondrial motility during hippocampal neuron development [J]. J Neurosci, 2019, 39(5): 802-813.
[19] 李欢欢,张佳,李春杰,等.监测早产儿血红蛋白、25羟维生素D水平及其临床意义[J].解放军预防医学杂志, 2019, 37(10): 28-29.
Li HH, Zhang J, Li CJ, et al. Monitoring hemoglobin and 25 hydroxyvitamin D levels in preterm infants and their clinical significance [J]. PLA J of Preventive Medicine, 2019, 37(10): 28-29.(in Chinese)
[20] 王景刚,李庆云,余春宇,等.深圳市1～5岁脑性瘫痪儿童营养现状调查及影响因素分析[J].中国儿童保健杂志, 2023, 31(11): 1180-1184.
Wang JG, Li QY, Yu CY, et al. Survey on the nutritional status of cerebral palsy children aged 1 to 5 years and analysis of influencing factors in Shenzhen [J]. Chin J Child Health Care, 2023, 31(11): 1180-1184.(in Chinese)
[21] Ruiz Brunner MLM, Cieri ME, Rodriguez Marco MP, et al. Nutritional status of children with cerebral palsy attending rehabilitation centers [J]. Dev Med Child Neurol, 2020, 62(12): 1383-1388.
[22] Cieri ME, Ruiz Brunner MM, Condinanzi AL, et al. Nutritional status and dietary intake of children and adolescents with cerebral palsy [J]. Clin Nut ESPEN, 2023, 57: 391-398.