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Prevalence of cerebral palsy with Gross Motor Function Classification System levels IV and V in children in Israel: a cross-cultural comparison

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Abstract

Purpose

Cerebral palsy is the most common physical disability in childhood. Our aim was to study the prevalence of wheelchair-dependent cerebral palsy (equivalent to gross motor function classification system level IV/V) among Jewish and Arab children in Israel and to investigate differences between the children of the two population groups.

Methods

Children diagnosed with cerebral palsy born in the years 2005–2006 were located through the Israel National Insurance Institute database. Demographic and clinical data were retrieved from children’s records.

Results

Overall prevalence in Israel was 0.8 (0.7–0.9) per 1000 live births. The prevalence was significantly higher among Arabs (1.2:1000) than Jews (0.6:1000; OR = 1.6, 95% CI 1.2–2.1, p = 0.001) and was highest among Arabs in the South (Bedouins) (2.8:1000). Consanguinity among parents and low socioeconomic status were significantly more common among Arab children with wheelchair- dependent cerebral palsy compared with Jews. Higher rates of children with cerebral palsy following term pregnancy were found in Arabs. Extreme preterm births, very low birth weight, and emergent cesarean section were more common among Jews compared with Arabs.

Conclusions

This study revealed population group differences of cerebral palsy with Gross Motor Function Classification System levels IV and V. Higher rates of cerebral palsy, especially following term pregnancy in the Arab population, may be attributed to consanguinity and genetic factors. There is a need to tailor services to underserved population based on etiology: preterm births and genetic causes for the Jewish and Arab populations, respectively.

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Abbreviations

CP:

cerebral palsy

GAD1:

glutamate decarboxylase 1

GMFCS:

Gross Motor Functional Classification System

GSA:

gestational age

NII:

National Insurance Institute

WD CP:

wheelchair-dependent cerebral palsy

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Acknowledgments

The authors thank the district health officers: Drs. M. Gdalevitz, C. Stein-Zamir, O. Havkin, M. Cohen-Dar S. Rishpon, and R. Shefer, for their cooperation.

Funding

This study was conducted as part of the responsibilities of the Israel Ministry of Health to collect data on disabled children. The funding was available as part of the annual budget of the Israel Center for Disease Control, the Ministry of Health, for this goal.

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Author notes

  1. Orit Blumenfeld and Hilla Ben-Pazi contributed equally to this work.

Authors and Affiliations

  1. Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel

    Orit Blumenfeld & Tamy Shohat

  2. Pediatric Neurology, Shaare Zedek Medical Center, Shmuel Bait 6, 91031, Jerusalem, Israel

    Hilla Ben-Pazi

  3. Department of Child Development, Ministry of Health, Jerusalem, Israel

    Asher Ornoy & Adina Josef

  4. Hebrew University Hadassah Medical School, Jerusalem, Israel

    Asher Ornoy

  5. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Tamy Shohat

Authors
  1. Orit Blumenfeld
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  2. Hilla Ben-Pazi
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Correspondence to Orit Blumenfeld.

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Blumenfeld, O., Ben-Pazi, H., Ornoy, A. et al. Prevalence of cerebral palsy with Gross Motor Function Classification System levels IV and V in children in Israel: a cross-cultural comparison. Childs Nerv Syst 36, 411–416 (2020). https://doi.org/10.1007/s00381-019-04262-5

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  • DOI: https://doi.org/10.1007/s00381-019-04262-5

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