Growth and nutritional status in residential center versus home-living children and adolescents with quadriplegic cerebral palsy

J Pediatr. 2007 Aug;151(2):161-6. doi: 10.1016/j.jpeds.2007.02.060. Epub 2007 Jun 22.

Abstract

Objective: To describe growth and nutrition in nonambulatory youth (<19 years of age) with cerebral palsy (CP) living in residential centers compared with similar youth living at home.

Study design: A multicenter, cross-sectional, single observational assessment of 75 subjects living in a residential care facility compared with 205 subjects living at home. Primary outcome measures included anthropometric measures of height, weight, triceps, and subscapular skinfolds, and mid-upper-arm muscle area. Z scores were calculated from reference values for healthy children. Age, use of a feeding tube, and Gross Motor Functional Classification System (GMFCS) level were included as important confounders.

Results: Use of a feeding tube was associated with higher skinfold Z scores, and a significantly higher percentage of the residential subjects had a feeding tube. Height, weight, and arm-muscle area Z scores all diverged (negatively) from reference values with age, and the residential subjects were on average older than the home-living subjects. After controlling for age, GMFCS level and use of a feeding tube, residential living was associated with significantly greater weight, height, skinfold thicknesses, and mid-arm muscle area Z scores.

Conclusion: Poor growth and nutrition in children with CP is a prevalent, important, and complex problem. Although factors intrinsic to the condition of CP likely play a significant role, it is also clear that environmental factors, including the living situation of the child, can have an impact.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anthropometry
  • Caregivers*
  • Cerebral Palsy / complications
  • Cerebral Palsy / diagnosis
  • Cerebral Palsy / physiopathology*
  • Child
  • Child Development*
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Growth*
  • Humans
  • Male
  • Multivariate Analysis
  • Nutritional Status*
  • Probability
  • Quadriplegia / complications
  • Quadriplegia / diagnosis
  • Quadriplegia / physiopathology*
  • Residential Facilities*
  • Risk Assessment
  • Severity of Illness Index