Nutrition and growth in children with cerebral palsy: setting the scene

Sullivan, Peter B.

doi:10.1038/ejcn.2013.222

Cited by 32 publications

(17 citation statements)

References 7 publications

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“…Gastrostomy placement has become widely used, but understanding correlated factors of tube feeding is poorly explored. There is a need for guidelines for the screening and nutrition management of children with CP for nonexperts . We developed and validated a model to identify factors associated with placement of gastrostomy in adolescents with DDs and CP.…”

Section: Discussionmentioning

confidence: 99%

Predictive Model for Gastrostomy Placement in Adolescents With Developmental Disabilities and Cerebral Palsy

et al. 2019

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Background Factors associated with gastrostomy placement in adolescents with developmental disabilities (DDs) and cerebral palsy (CP) are poorly investigated. We aimed to develop and validate a machine learning (ML) model for gastrostomy placement in adolescents with DDs and CP. Methods We performed a multinational, double‐blinded, case‐control study including 130 adolescents with severe DD and CP (72 males, 58 females; mean age 16 ± 2 years). Data on etiology, diagnosis, spasticity, epilepsy, clinical history, and functional assessments such as the Eating and Drinking Ability Classification System, Manual Ability Classification System, and Gross Motor Function Classification System were collected between 2005 and 2015. Analysis included Fisher exact test, multiple logistic regressions, and a supervised ML model, named PredictMed, to identify factors associated with gastrostomy placement. “Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis” guidelines were followed. Results Poor motor function (P < 0.001), trunk muscle tone disorder (P < 0.001), male gender (P < 0.01), epilepsy (P = 0.01), and severe neuromuscular scoliosis (P = 0.04) were factors linked with gastrostomy placement in univariate analysis. Epilepsy (P = 0.03), poor motor function (P = 0.04), and male gender (P = 0.04) were associated with gastrostomy placement in multivariate analysis with 95% accuracy. Conclusion Epilepsy, poor motor function, trunk muscles tone disorder, and male gender were accurate, sensitive, and specific factors associated with gastrostomy need.

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Section: Discussionmentioning

confidence: 99%

Predictive Model for Gastrostomy Placement in Adolescents With Developmental Disabilities and Cerebral Palsy

et al. 2019

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“…In 2017, the European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) published a consensus statement (ESP-GHAN guidelines) on the diagnosis and management of gastrointestinal and nutritional complications in children with neurological disability [1], based upon a systematic review of medical literature and experts' opinion. The number of these children is estimated not to decline in the next years, and their life expectancy to increase [2]. Nonetheless, the nutritional issues and growth deficits in this group of children are often considered to be of low priority or under recognised by healthcare providers [2].…”

Section: Introductionmentioning

confidence: 99%

“…The number of these children is estimated not to decline in the next years, and their life expectancy to increase [2]. Nonetheless, the nutritional issues and growth deficits in this group of children are often considered to be of low priority or under recognised by healthcare providers [2]. Therefore, focusing on their nutritional concerns is a crucial part of their overall clinical management.…”

Section: Introductionmentioning

confidence: 99%

“…Recent prevalence data reported 2.11 patients with cerebral palsy per 1000 live births and as high as 59.18 per 1000 live births among neonates weighing less than 1500 g [5]. Notably, despite the survival of preterm neonates has increased, the proportion with severe disability is the same [2,6]. Different factors may explain the increased prevalence of NI, such as higher numbers of multiple births, which often result in preterm births, and a gradual improvement of life expectancy [2], with survival curves for 10-year old boys with CP showing a 50% survival into their late 20s (http://www.lifeexpectancy.org/survival.shtml).…”

Section: Introductionmentioning

confidence: 99%

“…Notably, despite the survival of preterm neonates has increased, the proportion with severe disability is the same [2,6]. Different factors may explain the increased prevalence of NI, such as higher numbers of multiple births, which often result in preterm births, and a gradual improvement of life expectancy [2], with survival curves for 10-year old boys with CP showing a 50% survival into their late 20s (http://www.lifeexpectancy.org/survival.shtml). As a consequence of the increased life expectancy of NI children, the rate of feeding difficulties and gastrointestinal complaints also increased.…”

Section: Introductionmentioning

confidence: 99%

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Top-ten tips for managing nutritional issues and gastrointestinal symptoms in children with neurological impairment

Dipasquale¹,

Gottrand²,

Sullivan³

et al. 2020

Ital J Pediatr

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The prevalence of children with neurological impairment (NI) presenting feeding difficulties and gastrointestinal symptoms is rising. The most recent guidelines recommend early nutritional assessment and intervention in order to prevent undernutrition and growth failure, along with the proper diagnosis and treatment of some frequent gastrointestinal symptoms, such as gastroesophageal reflux disease (GERD) and constipation, which can further worsen the feeding process and nutritional status. Nonetheless, the nutritional issues and growth deficits of children with NI are often considered to be of low priority or under recognised by healthcare providers. The present article proposes ten top tips that highlight the major points along the nutritional management pathway of NI children. The implementation of these tips in all healthcare settings could potentially improve patient outcomes and reduce morbidity and mortality.

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