Multi-factor Logistic regression analysis on risk factors of prenatal infantile cerebral palsy

Hongbin QIU; Zhiguo WANG; Xiaojie LI; Binyou WANG; Zhimei JIANG

ABSTRACT

BACKGROUND:

The risks in pregnancy to the developing fetus result in cerebral palsy after delivery. Therefore, the study on etiology of cerebral palsy should transfer to biological field of embryonic development and stress on multi-factor analysis on relevant environment of pregnant mother,hereditary factors and relevant diseases.

OBJECTIVE:

To analyze the main risks of incidence of infantile cerebral palsy.

DESIGN:

Pair design at ratio of 12 and Logistic regression analysis of multi-factors were applied.

SETTING:

Prevention Medical Research Room of Jiamusi University and Department of Epidemiology, College of Public Health, Harbin Medical University.

PARTICIPANTS:

Totally 103 cases of infantile cerebral palsy were collected from Jiamusi Treatment and Education Center of Cerebral palsy,Shanyang Pediatrics Hospital and Qingdao Pediatrics Hospital from December 2002 to September 2003, of which, 68 cases were male and 35 cases were female. The guardians were in the know and agreed with the investigation. The pair principle at ratio of 12 was adopted, based on which, 206 cases of sick children with non-cerebral palsy and disorders in neurological system and healthy children treated at same period in the hospitals were collected as the control. The match conditions in the control were same sex, same nationality and difference in age ± 3 months.sy and healthy children was self-designed. The investigated items included mainly Factors before delivery (hereditary factors) family history of similar disease; mother's factor general situations, such as occupation, educational background and age of delivery; behavioral factors of birth including times of pregnancy, times of delivery and abnormal delivery; healthcare and nutrient in pregnancy such as examination before delivery and intakes of various foods; sickness or abnormal manifestations in pregnancy including pathogen infection, pregnant syndromes and vaginal bleeding; medication in pregnancy, fetal placents factors such as neck winding, mass weight of birth, twin pregnancy, factors during delivery (complications in delivery,methods of delivery) and neonatal factors (various kinds of disorders in neonates). Questionnaire of investigation was performed by looking-up medanalysis was done on single factor and multi-factors. The factors that presented statistical significance in single-factor analysis, significant difference (P ＜ 0.05) and P value near to 0.05 were adopted to establish the model of multiple Logistic regression of main risks of cerebral palsy and conditional Logistic regression analysis was carried on.MAIN OUTCOME

MEASURES:

Analysis on the effects of factors before delivery, during delivery and in neonatal phase on incidence of cerebral palsy.

RESULTS:

Totally 103 cases of cerebral palsy and 206 cases of healthy factors Occupation of mother was associated with cerebral palsy. Worker and age ≥34 years were the risks of cerebral palsy (OR=13.333, 2.864,eating fish and sea products in pregnancy, pre-delivery body temperature,mass weight of birth ＞ 4 000 g and pregnant weeks of 37 to 42 were the protective factors of cerebral palsy (OR=0.028-0.576, P ＜ 0.05-0.01); abnormal delivery history and vaginal bleeding in pregnancy were the risks of ery Apgar score and caesarian section were the protective factors of cerebral palsy (OR=0.458, 0.343, P ＜ 0.01); forceps delivery and delivery with oxytocin were the risks ofcerebral palsy (OR=16.338, 2.116, P ＜ 0.01,of newborn and neonatal intracranial hemorrhage were the risks of cerebral sion

analysis:

Forceps delivery was the highest risk (OR =70.668) and the sequence risk degree from high to low was asphyxia of newborn, elder age of pregnant mother, vaginal bleeding in pregnancy and abnormal mass weight of birth (OR=19.083-4.138, P ＜ 0.05-0.01). Eating fish and sea products in pregnancy and caesarian section were the protective factors (OR=0.324; 0.262, P ＜ 0.01, 0.05).

CONCLUSION:

Risks of cerebral palsy are mainly focused on pregnant period and perinatal period. It is suggested to prevent and eliminate actively various risks of cerebral palsy before, during and after delivery (such as forceps delivery, asphyxia of newborn, elder age of pregnant mother,vaginal bleeding in pregnancy and abnormal mass weight of birth) so as to reduce the incidence rate of cerebral palsy.