Early intervention and follow-up programs among children with cerebral palsy in Moldova: Do they make a difference? [post]

2019 unpublished
Aim To study whether early intervention services (EI) and a follow-up program (FU) influence outcomes of children with cerebral palsy (CP) in Moldova. Methods Records from 351 children with CP in Moldova born during 2009 and 2010 were retrieved from hospital and orphanage archives between 1 July 2016 and 30 September 2017. We investigated the proportion enrolled in EI and FU at the Early Intervention Centre Voinicel and at the Institute of Mother and Child. Logistic regression analyses were
more » ... ied to calculate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) for outcomes in children enrolled and not enrolled. Results Among all children with CP, 166 (47%) were enrolled in EI and FU. Of the 51 children born extremely preterm (gestational age ≤31 weeks), 46 (90%) were enrolled, compared to 97 (39%) of the 250 children born at term. Among 110 non-walking children with CP, 82 (74%) were enrolled into EI and FU, compared to 84 (35%) of 241 able to walk. There was no difference in outcomes of associated impairments between those enrolled or not enrolled in EI and FU. However, the subgroup analyses showed that among all children with CP the risk of contractures was five times higher among those not enrolled, regardless of GMFCS level (OR = 5.474, 95% CI 3.306-9.063, p <0.000). Conclusion In Moldova, EI and FU seem to be offered mostly to extremely preterm and non-walking children with CP. The results indicate a decreased risk for contractures in these children. Background 3 Cerebral palsy (CP) is an umbrella term covering disorders of movement and posture, leading to activity limitations, caused by non-progressive lesions or malformations in the immature brain [1] . Accompanying disturbances of sensation, perception, cognition, communication and behaviour are frequent, as are secondary musculoskeletal problems and epilepsy [1] . The brain lesion is non-progressive, but its consequences do change over time, and can be barriers to activity and participation in different life arenas [2] .
doi:10.21203/rs.2.13158/v1 fatcat:3dprx7cqdfhorlhb3qpyfbicd4