Developing a Cerebral Palsy Risk Score for Newborns
Chuenchom Chueluecha MD¹, Warangkana Deeprasertdamrong MD¹, Paskorn Sritipsukho MD² , ³
Affiliation :
¹ Department of Rehabilitation Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand ² Department of Pediatric, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand ³ Center of Excellence in Applied Epidemiology, Thammasat University, Pathum Thani, Thailand
Background : Cerebral palsy (CP) causes developmental delays, affecting quality of life. Many risk factors are theorized however, no total risks
summary exists, nor a CP prediction score for newborns. The result is under surveillance, treatment delays, and non-rectifiable complications.
Objective : To establish total risk factors and create a prediction score for assessing CP neonatal risk before discharge. A prediction score has great utility for medical professionals and parents in screening high-risk patients and developing adequate monitoring systems.
Materials and Methods : Using a case-controlled retrospect of children aged 0 to 2 years, born at Thammasat University Hospital, Thailand between 2005 and 2014, prenatal, perinatal, and postnatal risks were compared between children without CP as control, and those diagnosed with CP as case, by multivariable logistic regression. Predictors were assessed with area under the receiver operating characteristic (AuROC), odds ratio (OR), 95% confidence interval (CI), p-value, and clinical predisposition. Logistic regression was applied, including calibration, validation, and categorization of risk.
Results : Cerebral and non-cerebral malformations, multi-fetal gestation, low birthweight, and neonatal sepsis were found as potential predictors, scoring 3, 1.5, 1, 2, 2.5, respectively, AuROC being 0.86 (95% CI 0.79 to 0.92). Low, moderate, and high-risk groups were set with scores of less than 1, 1.5 to 3, and more than 3.5, respectively.
Conclusion : The present predictive CP risks and scoring system shows excellent discrimination power. If newborns were categorized in the high- risk group, close monitoring and surveillance are needed.
Received 16 June 2020 | Revised 14 October 2020 | Accepted 15 October 2020
doi.org/10.35755/jmedassocthai.2021.02.11570
Keywords :
Cerebral palsy, Risk score, Prenatal, Perinatal, Postnatal
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