Objective To analyze the risk factors for comorbid intellectual disability (ID) and its severity in children with cerebral palsy (CP), so as to provide evidence for early clinical intervention and personalized treatment plans. Methods A retrospective study was conducted on 392 children with CP (aged 1 - 16 years, 270 males and 122 females) hospitalized at the Third Affiliated Hospital of Jiamusi University from January 2015 to November 2024.Clinical data and assessment results from the Gesell Developmental Scale (GDS), Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV)/Wechsler Intelligence Scale for Children-Chinese Fourth Edition (WISC-IV), and Gross Motor Function Classification System (GMFCS) were retrospectively collected.Intellectual function was categorized as normal, mild, moderate, or severe based on developmental quotient (DQ)/intelligence quotient (IQ).χ2test was used for univariate analysis to compare intergroup differences and identify significant factors, followed by ordinal logistic regression to determine risk factors influencing ID severity in CP children. Results Univariate analysis revealed significant differences among the four groups in the proportions of preterm birth history (χ2=6.476), hyperbilirubinemia history (χ2=17.248), GMFCS level IV-V (χ2=117.291), spastic quadriplegia (χ2=32.023), and maternal medication use during pregnancy (χ2=36.695) (all P<0.05).Ordinal logistic regression identified hyperbilirubinemia history (OR=2.465, 95% CI: 1.619 - 3.747), preterm birth history (OR=1.478, 95% CI: 1.002 - 2.181), and GMFCS level Ⅳ-Ⅴ (OR=10.166, 95% CI: 6.166 - 16.743) as independent risk factors for increased ID severity in CP children (P<0.05). Conclusions Hyperbilirubinemia history, preterm birth, and severe motor impairment (GMFCS Ⅳ-Ⅴ) exacerbate intellectual disability in children with CP.Strengthened monitoring of high-risk factors, regular assessments, early intervention, and tailored rehabilitation programs are recommended to promote optimal neurodevelopmental outcomes.
Key words
cerebral palsy /
intellectual disability /
neonatal hyperbilirubinemia /
preterm birth /
Gross Motor Function Classification System
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