1 - Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa.
2 - Unidade Funcional de Neonatologia, Área de Pediatria, Centro Hospitalar Universitário de Lisboa Central, Lisboa.
- 23.º Congresso Nacional de Pediatria, Centro de Congressos do Estoril ,25 a 27 de outubro de 2023.
Background & objective. Congenital anomalies (CA) are associated to cerebral palsy (CP). To study this relationship we need data that allow for powerful analysis. We aim to assess the proportion of CA among children with CP and the distribution of clinical subtypes and manifestations among children with and without CA.
Methods. We performed a probabilistic linkage of data from two national population-based registries: National Surveillance of Cerebral Palsy (PVNPC) and Congenital Anomalies Registry (RENAC), which respectively follow the guidelines of Surveillance of Cerebral Palsy in Europe and European Surveillance of Congenital Anomalies. The linking variables were: date of birth, sex, number of weeks of gestation, birth weight, mother's residence at time of delivery, and mother's age. Subsequently, a comparative study of children born from 2001 to 2012 was conducted. The associations between CA and the CP subtypes and clinical manifestations were explored by odds ratio (OR), with 95% confidence intervals (95%CI).
Results. The linkage between the two databases allowed validation, complement and increase of the information about CA in all reported children with CP. Among 1057 children with CP 23.8% (252) had at least one reported CA, mostly malformations of the central nervous system (63.1% of the children with CA) and cardiac malformations (20.0%). The ataxic CP subtype was more prevalent in children with CA than otherwise (15.1% vs 3.0%). Children with CP and CA had more severe gross- and fine-motor impairments (GMFCS level IV-V 47.0% vs 35.6% and MACS level IV-V 43.7% vs 32.5%).
Conclusions. These results suggest that a high proportion of children with CP have CA (around 24%), this condition is associated with a more severe motor function, being an important factor for primary and secondary prevention of CP.
Palavras Chave: cerebral palsy, congenital anomalies, databases, linkage, National registries