Early human development · 2026
Value of caregivers report at six months of age in predicting cerebral palsy - A prospective cohort study.
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Strøm Marianne, Wilcox Allen J, Tollånes Mette, Lie Rolv Terje, Forthun Ingeborg, Strandberg-Larsen Katrine, Moster Dag
Аннотация
OBJECTIVE: Early identification of cerebral palsy (CP) in children without known risk factors is challenging. Parent-identified concerns are important in early CP detection. This study assesses the value of caregiver-reported infant characteristics at age six months in identifying CP among term-born singletons.
METHOD: Prospective data on term-born singletons from one birth cohort in Norway (1999-2009) and one in Denmark (1996-2003) were linked to their national registries. CP diagnosis, subtype and severity were identified in CP registries. Relative risks (RR) for CP were calculated by caregiver-reported developmental and health-related concerns at six months. Positive and negative predictive values, sensitivity, specificity and area under the receiver operating characteristic curve (AUC) were assessed. Follow-up time was 6-16 years.
RESULTS: Among 150,100 term-born singleton children, there were 203 with CP. Strongest associations were observed for concerns about "general motor delay" (RR 65; 95% CI 44-96), "not handle toy with both hands" (RR 161; 95% CI 109-239) and "not grab toy" (RR 72; 95% CI 50-105). Caregivers of affected infants reported more colic, respiratory infections, seizures and caregiving difficulty. Highest positive predictive value was seen for "not handle toy with both hands" (17%) and highest sensitivity for concerns about "general motor delay" (49%). Associations were strongest for dyskinetic subtype and GMFCS level IV-V. Combining all characteristics gave an AUC of 0.81.
CONCLUSION: Caregivers of term-born singletons with CP recognize signs of CP at six months, particularly early handedness. Concerns about most characteristics had limited diagnostic prediction alone but jointly add value to early CP identification.
METHOD: Prospective data on term-born singletons from one birth cohort in Norway (1999-2009) and one in Denmark (1996-2003) were linked to their national registries. CP diagnosis, subtype and severity were identified in CP registries. Relative risks (RR) for CP were calculated by caregiver-reported developmental and health-related concerns at six months. Positive and negative predictive values, sensitivity, specificity and area under the receiver operating characteristic curve (AUC) were assessed. Follow-up time was 6-16 years.
RESULTS: Among 150,100 term-born singleton children, there were 203 with CP. Strongest associations were observed for concerns about "general motor delay" (RR 65; 95% CI 44-96), "not handle toy with both hands" (RR 161; 95% CI 109-239) and "not grab toy" (RR 72; 95% CI 50-105). Caregivers of affected infants reported more colic, respiratory infections, seizures and caregiving difficulty. Highest positive predictive value was seen for "not handle toy with both hands" (17%) and highest sensitivity for concerns about "general motor delay" (49%). Associations were strongest for dyskinetic subtype and GMFCS level IV-V. Combining all characteristics gave an AUC of 0.81.
CONCLUSION: Caregivers of term-born singletons with CP recognize signs of CP at six months, particularly early handedness. Concerns about most characteristics had limited diagnostic prediction alone but jointly add value to early CP identification.