Risk Factors for Cerebral Palsy in Moldova
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GINCOTA BUFTEAC, Ecaterina, JAHNSEN, Reidun, SPINEI, Larisa, ANDERSEN, Guro. Risk Factors for Cerebral Palsy in Moldova. In: Medicina (Kaunas, Lithuania), 2021, nr. 6(57), pp. 1-15. ISSN 1010-660X. DOI: https://doi.org/10.3390/medicina57060540
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Medicina (Kaunas, Lithuania)
Numărul 6(57) / 2021 / ISSN 1010-660X /ISSNe 1648-9144

Risk Factors for Cerebral Palsy in Moldova

DOI:https://doi.org/10.3390/medicina57060540

Pag. 1-15

Gincota Bufteac Ecaterina12, Jahnsen Reidun34, Spinei Larisa5, Andersen Guro67
 
1 Oslo Metropolitan University,
2 Center for Early Intervention „Voinicel”,
3 Oslo University Hospital,
4 University of Oslo,
5 ”Nicolae Testemițanu” State University of Medicine and Pharmacy,
6 Vestfold Hospital Trust,
7 Norwegian University of Science and Technology, Trondheim
 
 
Disponibil în IBN: 14 iunie 2021


Rezumat

Background and Objectives: This is the first study assessing risk factors for cerebral palsy (CP) among children born in Moldova. The aim of this study was to identify and describe risk factors for cerebral palsy (CP) among children born in Moldova, which is one of the low-middle income countries in Europe. Materials and Methods: We identified 351 children with CP born during 2009 and 2010 in Moldova. Detailed information on 417 children without CP served as a reference group. Logistic regression analyses were applied to the calculate crude and adjusted odds ratios (OR) for CP with 95% confidence intervals (CI) in addition to attributable fraction (AF). Results: Among children with CP (40.5% girls), 26% had spastic unilateral, 54% bilateral, 13% dyskinetic, 5% ataxic and 2% unclassified CP. Significant risk factors for CP included maternal alcohol consumption during pregnancy (OR 1.7, p = 0.002), maternal hypertension (OR 2.0, p < 0.001), children born to mothers from the rural areas (OR 1.6, p < 0.001), maternal age ≥35 years (OR 0.6, p = 0.018), maternal epilepsy (OR 4.3, p < 0.001), breech delivery (OR 3.1, p = 0.001), home births (OR 6.3, p = 0.001), umbilical cord around neck (OR 2.2, p < 0.001), AVD (OR 3.1, p < 0.001), male gender (OR 1.3, p < 0.001), SGA (OR 1.3, p = 0.027), multiple gestations (OR 1.7, p < 0.001) and hyperbilirubinemia (OR 4.5, p < 0.001). Multivariable analyses showed that the AF of CP was 64% for rural residence (OR 2.8, p = 0.002), 87% for home birth (7.6, p = 0.005), 79% for pre-labor rupture of membrane (OR 4.9, p = 0.001), 66% for breech delivery (OR 2.9, p = 0.002) and 81% for hyperbilirubinemia (OR 5.4, p < 0.001). Conclusions: A combination of factors related to the mother, the delivery and the child were risk factors for CP in Moldova, many of them possibly avoidable. Improved pregnancy and maternity care would potentially reduce the risk of CP. A national CP registry in Moldova is suggested as an opportunity to follow up on these findings.

Cuvinte-cheie
asphyxia, cerebral palsy, hyperbilirubinemia, Moldova, prevention, quality registry, risk factors