Beretta-Piccoli M1, Forni R2,3, Pervan Z3, Haring-Tosi S3, Wehrli B2, Ramelli GP4
1University of Applied Sciences and Arts of Southern Switzerland, Rehabilitation Research Laboratory 2rLab, Manno, Switzerland, 2University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland, 3San Giovanni Hospital, Service of Physiotherapy, Bellinzona, Switzerland, 4San Giovanni Hospital, Unit of Neuropediatrics, Department of Pediatrics, Bellinzona, Switzerland
Background: Cerebral palsy (CP) is the most common pervasive childhood motor disability, with estimated global incidence between 2 and 3 per 1000 live births. Little information is currently available in literature concerning children affected by CP in the different regions of Switzerland, mainly because epidemiologic data have not been systematically collected. Recently we published a pilot study on CP prevalence among children in northeastern Switzerland.
Purpose: To collect data about the prevalence and severity of CP in children born in Southern Switzerland (canton of Ticino) and to compare these data with those of another Swiss region.
Methods: A retrospective review of medical records was undertaken. Children born in the canton of Ticino from January 1, 2000 to December 31, 2013 and diagnosed with CP were eligible for inclusion. Extraction of data from the medical records was done by four physical therapists (FR, PZ, WB and H-TS) under the supervision of a neuropediatrician (RGP). Patient data were entered into a standardized case report form derived from the original form of the Surveillance of Cerebral Palsy Network in Europe (SCPE). At least 20 variables, corresponding to the required categories of the SCPE data collection form, were extracted from each medical record. CP was classified into three types: spastic (with bilateral and unilateral subtypes), dyskinetic (with choreo-athetotic and dystonic subtype) and ataxic. Normality was verified through the Shapiro-Wilk test. Comparisons between data of southern and northeastern Switzerland were investigated using a Mann-Whitney U test and a Chi-square test of homogeneity for continuous and multinomial variables, respectively.
Results: 49 children (25 females, median age 11) met the inclusion criteria. Prevalence of CP was 0.14%, with 71.4% of children affected by a spastic CP. Comparisons between the extracted variables of the two populations resulted in four significant differences: delivery mode (p 0.005), birth order (p 0.0001), multiple births (p 0.05) and mother age (p=0.05).
Conclusion(s): Four medical variables were identified as significantly different across the two cohorts, whereas other 15 variables were not. Prevalence of CP in the canton of Ticino was slightly lower with respect to northeastern Switzerland. Data retrieved in the present study will be entered into the Swiss CP registry (created in 2017) and will be used to better anticipate therapeutic, educational and clinician needs in the future.
Implications: Results about prevalence, frequency and severity of CP in the canton of Ticino may be useful in everyday clinical practice, because, as demonstrated in other countries, the data may be used to develop effective protocols for multidisciplinary management of secondary health complications (such as hip dislocation) of children with CP. Thus, systematic data collection in hospitals using standardized and validated protocols and forms, should be encouraged in order to provide a nationwide registry to identify factors that contribute to a good long-term outcome and quality of life of children with CP.
Keywords: motor disability, prevalence, delivery mode
Funding acknowledgements: none
Purpose: To collect data about the prevalence and severity of CP in children born in Southern Switzerland (canton of Ticino) and to compare these data with those of another Swiss region.
Methods: A retrospective review of medical records was undertaken. Children born in the canton of Ticino from January 1, 2000 to December 31, 2013 and diagnosed with CP were eligible for inclusion. Extraction of data from the medical records was done by four physical therapists (FR, PZ, WB and H-TS) under the supervision of a neuropediatrician (RGP). Patient data were entered into a standardized case report form derived from the original form of the Surveillance of Cerebral Palsy Network in Europe (SCPE). At least 20 variables, corresponding to the required categories of the SCPE data collection form, were extracted from each medical record. CP was classified into three types: spastic (with bilateral and unilateral subtypes), dyskinetic (with choreo-athetotic and dystonic subtype) and ataxic. Normality was verified through the Shapiro-Wilk test. Comparisons between data of southern and northeastern Switzerland were investigated using a Mann-Whitney U test and a Chi-square test of homogeneity for continuous and multinomial variables, respectively.
Results: 49 children (25 females, median age 11) met the inclusion criteria. Prevalence of CP was 0.14%, with 71.4% of children affected by a spastic CP. Comparisons between the extracted variables of the two populations resulted in four significant differences: delivery mode (p 0.005), birth order (p 0.0001), multiple births (p 0.05) and mother age (p=0.05).
Conclusion(s): Four medical variables were identified as significantly different across the two cohorts, whereas other 15 variables were not. Prevalence of CP in the canton of Ticino was slightly lower with respect to northeastern Switzerland. Data retrieved in the present study will be entered into the Swiss CP registry (created in 2017) and will be used to better anticipate therapeutic, educational and clinician needs in the future.
Implications: Results about prevalence, frequency and severity of CP in the canton of Ticino may be useful in everyday clinical practice, because, as demonstrated in other countries, the data may be used to develop effective protocols for multidisciplinary management of secondary health complications (such as hip dislocation) of children with CP. Thus, systematic data collection in hospitals using standardized and validated protocols and forms, should be encouraged in order to provide a nationwide registry to identify factors that contribute to a good long-term outcome and quality of life of children with CP.
Keywords: motor disability, prevalence, delivery mode
Funding acknowledgements: none
Topic: Paediatrics: cerebral palsy
Ethics approval required: Yes
Institution: Swiss Italian Health and Sociality Department, Bellinzona, Switzerland
Ethics committee: Ethics Committee Ticino
Ethics number: CE 2987
All authors, affiliations and abstracts have been published as submitted.
