PATTERN OF GROWTH IN CHILDREN WITH CEREBRAL-PALSY

Objective To provide a growth reference standard for children with qua driplegic cerebral palsy (QCP). Growth references specific to children with children palsy would facilitate uniformity in clinical appraisal of their growth and nutritional status and would simplify comparative interpretation of growth data. Design Weights and lengths were obtain ed according to standardized procedures. Measurements were taken at ti me of visit to an orthopedic clinic and from retrospective review of c harts. Subjects Three hundred sixty children with QCP. Growth data wer e based on 1,630 observations. Analysis Growth curves representing the 10th, 50th, and 90th percentiles were estimated using a smoothing spl ines technique. Statistical bootstrapping was performed to confirm sig nificant differences from the growth charts of the National Center for Health Statistics (NCHS). Results Growth charts were constructed for boys and girls, aged 0 to 120 months, depicting length for age, weight for age, and weight for length. Average differences in length for age , weight for age, and weight for length between children with QCP and NCHS standards were -2.3 z, -2.4 z, -1.3 z for boys, and -2.1 z, -2.1 z, -1.1 z for girls. Children with QCP fell progressively behind in st ature and weight. Compared with their NCHS counterparts, they were 5% shorter at 2 years of age and more than 10% shorter at 8 years of age. Application Charts representing the pattern of growth in children wit h QCP should be accessible to parents and health care professionals to facilitate evaluation and monitoring of nutritional status.