Background

In European and North American countries, stunting and malnutrition are common in children with cerebral palsy (CP), especially those with multiple disabilities. The extent of this problem in children with CP in North African countries is still unknown.

Aims

To evaluate feeding problems and growth in a sample of North African multidisabled children with CP and to determine the factors associated with malnutrition in this population.

Method

We conducted a cross-sectional study including multidisabled children with severe CP. Anthropometric measurements (body weight, height, mid-upper arm circumference and triceps skinfold thickness) were performed. In addition, a thorough nutritional survey was conducted including feeding time and the presence of signs in favor of gastrointestinal problems.

Results

We included 40 children, mainly boys (60 %) with a mean age of 6.4 ± 3.7 (range 2–16 years). The nutritional survey had revealed the presence of dysphagia, constipation and gastroesophageal reflux in 55 %, 67.5 % and 70 % of cases, respectively. Sixty-five percent of children had a mealtime over 30 min. Based on World Health Organization (WHO) growth charts, 67.5 % of children were underweight. Forty percent of the children had their weight below the 20th percentile, 5 % and 7.5 % had their height and BMI below the 5th percentile according to CP specific growth charts. Triceps skinfold thickness and mid-upper arm circumference were below the 5th percentile in 50 % and 55 % of cases, respectively. Age (p = 0.047) and constipation (p = 0.003) were identified as predictors of malnutrition.

Conclusions

Growth parameters and nutritional status are significantly altered in in our sample of North African multidisabled children with CP with a high prevalence of feeding problems represented especially by dysphagia, constipation and GER. Among the studied factors age and constipation may predict the existence of undernutrition.

中文翻译：

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北非脑瘫残疾儿童样本中的喂养问题和营养不良相关因素

背景

在欧洲和北美国家，脑瘫（CP）儿童，尤其是多重残疾儿童，普遍存在发育迟缓和营养不良。这个问题在北非国家患有 CP 的儿童中的严重程度仍然未知。

宗旨

评估北非患有 CP 的多重残疾儿童样本的喂养问题和生长情况，并确定与该人群营养不良相关的因素。

方法

我们进行了一项横断面研究，包括患有严重 CP 的多重残疾儿童。进行人体测量（体重、身高、中上臂围和三头肌皮褶厚度）。此外，还进行了全面的营养调查，包括喂养时间和有利于胃肠道问题的迹象。

结果

我们纳入了 40 名儿童，主要是男孩 (60%)，平均年龄为 6.4 ± 3.7（范围 2-16 岁）。营养调查显示，分别有 55%、67.5% 和 70% 的病例存在吞咽困难、便秘和胃食管反流。65% 的儿童进餐时间超过 30 分钟。根据世界卫生组织 (WHO) 的生长图表，67.5% 的儿童体重不足。根据 CP 特定生长图表，40% 的儿童体重低于第 20 个百分位，5% 和 7.5% 的儿童身高和 BMI 低于第 5 个百分位。分别有 50% 和 55% 的三头肌皮褶厚度和中上臂周长低于第 5 个百分位数。年龄（p = 0.047）和便秘（p = 0.003）被确定为营养不良的预测因素。

结论

在我们的 CP 北非多重残疾儿童样本中，生长参数和营养状况发生了显着变化，喂养问题的发生率很高，尤其是吞咽困难、便秘和 GER。在研究的因素中，年龄和便秘可以预测营养不良的存在。