Journal of Rehabilitation Medicine 51-1CompleteIssue | Page 52

Cerebral palsy prevalence and risk factors
guardians refused permission for their children to enter
the study. There were 23,040 females and 27,556 males
(female:male 1:1.196). Of these, 822 children screened
CP-positive. Further examination resulted in 235 being
diagnosed as normal, 436 were diagnosed with transient
developmental delay, 26 with intellectual disability, 5
with muscular torticollis, and 120 with CP. Thus, the
true positive rate of the screening was 14.60%.
Regarding CP, the prevalence was 2.37% (95% CI)
1.95–2.79). There were 76 boys and 44 girls with CP.
The prevalence in male children was 2.76% (95%
CI 2.14–3.37%) and in female children 1.91% (95%
CI 1.34–2.47%), respectively. The χ 2 test showed no
significant difference in prevalence between sexes
(p > 0.05).
Risk factors
The following factors were excluded from the analysis
as they were reported less than 1% of the time: maternal
alcohol intake during pregnancy, X-ray examination
or computed tomography scanning during pregnancy,
maternal active smoking, and dystocia. The statistical
results of the univariate logistic regression analyses
are summarized in Table I.
The variables showing a significant correlation with
the occurrence of CP in univariate logistic regression
analyses (p < 0.10) were included in the multivariate
logistic regression analysis. For ordinal data, scatter-
plots were created with the independent variable on
49
the x-axis and probability of having CP on the y-axis.
Scatterplots of parental educational levels and mater-
nal education levels did not reveal a rectilinear trend.
Therefore, educational level was transformed into a
categorical variable and included in the multivariate
logistic regression analysis. However, scatterplots of
maternal passive smoking, abortion times, and the
nutritionl status of the mother, showed significant
rectilinear trends, and these factors were analysed di-
rectly in the multivariate logistic regression analysis.
The scatterplots are presented in Fig. 1.
Statistical results from the multivariate logistic
regression analysis are summarized in Table II. The
results reveal that the following are high-risk factors for
CP:moving into a newly painted room, complications
with concomitant diseases(including diabetes, hyper-
tension, anemia, heart disease, kidney disease) during
pregnancy, high gravidity (≥ 3), asphyxia (severe
respiratory depression at birth, the effective sponta-
neous breathing didn’t creat afer 1 minute from birth
and Apgar score is less than 7; umbilical artery blood
gases analysis: pH < 7.15), low birth weight (< 2,500
g), and HIE.
DISCUSSION
This cross-sectional study was a census of child-
ren under 7 years old recruited from 24 districts
and towns in 24 cities in China. The prevalence
of CP was 2.37 per 1,000 live births (95% CI
Table I. Statistical results of univariate logistic regression analyses
Factors OR (95% CI) Z value Standard error p-value
Paternal age
Maternal age
Paternal educational level
Maternal educational level
Household income per capita
Residence
Paternal history of contact with physical and chemical agents
Maternal history of contact with physical and chemical agents
Moving into a newly painted room during pregnancy
Family history of genetic diseases
Maternal concomitant diseases during pregnancy
Maternal medication history
Maternal nutritional status
Times of prenatal ultrasonography
Maternal passive smoking
Pre-pregnancy irregularity of menstrual cycles
Gravidity
Parity
Abortion times
History of abnormal pregnancy
Antepartum haemorrhage
Foetal times
Gestation (in weeks)
Mode of delivery
Abnormalities in labour progression
Asphyxia at birth
Birthweight
Neonatal diseases 2.1835 (1.6635, 2.8661)
1.8943 (1.4077, 2.5491)
2.0347 (1.4124, 2.9312)
2.6908 (1.8760, 3.8595)
0.3439 (0.1782, 0.6637)
0.8160 (0.3926, 1.6957)
2.7155 (0.5690, 12.9587)
6.2566 (2.2153, 17.6701)
5.6581 (2.0258, 15.8031)
11.9096 (4.1631, 34.0698)
5.7711 (3.5615, 9.3515)
8.6150 (4.2813,17.3357)
2.5097 (1.4131, 4.4572)
1.0387 (0.8598, 1.2549)
1.4340 (1.2085, 1.7016)
12.0430 (5.1374, 28.2311)
2.2980 (1.7201, 3.0700)
1.7331 (1.1405, 2.6336)
3.8493 (2.3934, 6.1908)
5.0559 (3.0589, 8.3567)
12.2558 (3.2738,45.8806)
6.0425 (1.6860, 21.6554)
2.5944 (1.8975, 3.5473)
0.6590 (0.4082, 1.0636)
3.8761 (2.2069, 6.8078)
27.2359 (10.497, 70.6672)
3.4117 (2.4057, 4.9238)
1.3044 (1.1943, 1.4245) 5.63
4.06
3.81
5.38
–3.18
–0.54
1.25
3.46
3.31
3.75
7.12
6.04
3.14
0.39
4.13
5.73
5.63
2.58
5.56
6.32
3.72
2.76
5.97
–1.71
4.71
6.79
6.76
5.91 0.3030
0.2869
0.3789
0.4951
0.1153
0.3045
2.1652
3.3142
2.9651
6.3867
1.4212
3.0736
0.7354
0.1001
0.1251
5.2347
0.3396
0.3700
0.9332
1.2962
8.2543
3.9352
0.4140
0.1609
1.1138
13.2492
0.6288
0.0586 < 0.001
< 0.001
< 0.001
< 0.001
0.001
0.586
0.210
0.001
0.001
< 0.001
< 0.001
< 0.001
0.002
0.693
< 0.001
< 0.001
< 0.001
0.011
< 0.001
< 0.001
< 0.001
0.006
< 0.001
0.088
< 0.001
< 0.001
< 0.001
< 0.001
OR: odds ratio; 95% CI: 95% confidence interval.
J Rehabil Med 51, 2019