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To determine the prevalence of comorbidities among children with cerebral palsy (CP) and risk-factors predictive of different comorbidities.

Objectives To determine the prevalence of comorbidities among children with cerebral palsy (CP) and risk-factors predictive of different comorbidities.

Methods Children aged 2-18 years with a confirmed diagnosis of CP were enrolled in this cross-sectional study undertaken between April 2018 and October 2021 at a tertiary care centre in India. Comorbidities were assessed in the following domains: motor function, cognition, vision, hearing, communication, epilepsy, sleep, pain, gastrointestinal dysfunction, and behaviour.

Results Among 436 children who were screened, 384 were study-eligible (Figure 1) and included mixed CP (110, 28.6%), spastic quadriparesis (92, 24%), spastic diplegia (70, 18.2%), dyskinetic CP (58, 15.1%), and hemiparetic CP (52, 13.5%) (Table 1). The most common comorbidities included visual impairment (357, 93%), epilepsy (245, 64%), impaired cognition (241, 62.7%), poor functional status (239, 62.2%), sleep impairment (176, 60.7%), pain (230, 60%), gastrointestinal dysfunction (224, 58.3%), language impairments (178, 46%) and behavioural abnormalities (165, 43%) (Table 2). As compared to hemiparetic CP, the odds (95% CI) of visual impairment, hearing impairment, communication abnormality, epilepsy, gastrointestinal dysfunction, pain, sleep impairment, and internalizing behaviour in a child with spastic quadriparesis were 1.82 (0.33-10.1), 9.47 (2.65-60.6), 98.7 (33.3-357), 8.59 (3.83-20.5), 2.77 (1.08-7.30), 15.6 (6.74-39.5), 14.0 (5.41-40.1), and 4.49 (1.85-12.7). Overall, the prevalence and severity of comorbidities were worst for spastic quadriparesis and mixed CP and worsened with increasing GMFCS scales (Table 3).

Conclusion These findings demonstrate a high prevalence of comorbidities beyond the functional domains, among children with CP. Identifying these is imperative for holistic care of children with CP.