Relationship between growth, age and eating and drinking ability in children with cerebral palsy in Argentina

Abstract

Malnutrition in children and adolescents with cerebral palsy (CP) is multicausal. It can be linked to motor compromise and their eating and drinking ability, impacting on their nutritional status and growth. Objective: To analyze the association between age groups and the level of the Eating and Drinking Ability Classification System (EDACS) with growth in children and adolescents with CP.

Observational, descriptive, cross-sectional study. Children and adolescents with CP from five provinces of Argentina were included. Data were collected from the Argentine CP Register through surveys and clinical histories. The variables were nutritional status, EDACS level and age. Growth was assessed by calculating weight/age, height/age and BMI/age z-scores. Categorical variables were described as percentages with [95% CI]. Normal data was presented with mean and standard deviations and non-normal data with median and ranges. T-test or Mann-Whitney test was performed as applicable (p<0.05).

181 children and adolescents were included. 154 (84.6% [78.5-89.5]) were children and 28 (15.4% [10.4-21.4]) adolescents. 105 (65.6% [58.1-72.4]) had severe motor impairment. According to EDACS, 99 (61.5% [53.9-68.6]) were severely compromised (level III, IV and V). Regarding height/age z-scores, adolescents were more compromised with a median of -2.75; [-3.9;1.76] z-score than children -1.89; [-3.1; -0.70] (p= 0.0363). BMI/age was more compromised for adolescents with -2.38; [-3.9; -0.03] z-score. Children with severe level of  EDACS had more compromised in weight/age (median -2.21 [-3.6; -1.1] z-score, p=0.0001), height/age (median -2.66 [-3.7; -1.6] z-score, p=0.0363) and BMI/age (-1.49 [-2.7; 0.0] z-score, p=0.0001) compared to those with  mild level of EDACS.

A relationship was observed between growth, age and EDACS level. There is greater compromise in growth in adolescents and those with severe compromise according to level of EDACS.