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Clinical features associated with epilepsy occurrence, resolution, and drug resistance in children with cerebral palsy: A population‐based study
Aim To investigate clinicoradiological features associated with epilepsy, its resolution, and drug resistance in children with cerebral palsy (CP). Method Data were gathered from the New South Wales/Australian Capital Territory CP Register, encompassing children with CP born between 2003 and 2015 (n...
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| Published in: | Developmental medicine and child neurology 2024-06, Vol.66 (6), p.793-803 |
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| container_issue | 6 |
| container_start_page | 793 |
| container_title | Developmental medicine and child neurology |
| container_volume | 66 |
| creator | Feroze, Nimra Karim, Tasneem Ostojic, Katarina Mcintyre, Sarah Barnes, Elizabeth H. Lee, Byoung Chan Badawi, Nadia Mohammad, Shekeeb S Paget, Simon Dale, Russell C. Gill, Deepak Kothur, Kavitha |
| description | Aim
To investigate clinicoradiological features associated with epilepsy, its resolution, and drug resistance in children with cerebral palsy (CP).
Method
Data were gathered from the New South Wales/Australian Capital Territory CP Register, encompassing children with CP born between 2003 and 2015 (n = 1916). Clinical features and the severity of impairments were compared among three groups: children with current epilepsy (n = 604), those with resolved epilepsy by age 5 years (n = 109), and those without epilepsy (n = 1203). Additionally, a subset of the registry cohort attending Children's Hospital Westmead (n = 256) was analysed to compare epilepsy and treatment characteristics between drug‐responsive (n = 83) and drug‐resistant groups (n = 147) using logistic regression and hierarchical cluster analysis.
Results
Manual Ability Classification System levels IV and V, intellectual impairment, and vision impairment were found to be associated with epilepsy in children with CP on multivariable analysis (p |
| doi_str_mv | 10.1111/dmcn.15807 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2899370939</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2899370939</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3657-419dfd695188d0335357f229c05d8ee22c81fd73c9981b80380d98eb830a24913</originalsourceid><addsrcrecordid>eNp9kUtO5DAQhi0EggZmwwGQl2hEwI-kY7Nr9fCSYNgw68ixK-CRO8nYsVB2HAFxxDkJbgIsqU1JpU9fqepH6ICSE5rq1Kx0e0ILQcoNNKP5XGaizOUmmhFCWUbnjO2g3RD-EkL4vMi30Q4XpJCc5TP0unS2tVo53IAaooeAVQidtmoAg5_s8Iihtw76MOJO6-g9tBqOcQI7FwfbtcdYtQYbHx_WQxsGlQBsW6wfrTMJnywaPNQ-7emVC-MZXuC-66NTa8X_55dahbQvDNGM-2irSQz8-Oh76M_F-f3yKru5u7xeLm4yna4os5xK05i5LKgQhnBe8KJsGJOaFEYAMKYFbUzJtZSC1oKkm40UUAtOFMsl5XvoaPL2vvsXIQzVygYNzqkWuhgqJqTkJZFcJvTnhGrfheChqXpvV8qPFSXVOoNqnUH1nkGCDz-8sV6B-UI_n54AOgFP6bHjN6rq1-3y9yR9A9oelLE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2899370939</pqid></control><display><type>article</type><title>Clinical features associated with epilepsy occurrence, resolution, and drug resistance in children with cerebral palsy: A population‐based study</title><source>Wiley</source><creator>Feroze, Nimra ; Karim, Tasneem ; Ostojic, Katarina ; Mcintyre, Sarah ; Barnes, Elizabeth H. ; Lee, Byoung Chan ; Badawi, Nadia ; Mohammad, Shekeeb S ; Paget, Simon ; Dale, Russell C. ; Gill, Deepak ; Kothur, Kavitha</creator><creatorcontrib>Feroze, Nimra ; Karim, Tasneem ; Ostojic, Katarina ; Mcintyre, Sarah ; Barnes, Elizabeth H. ; Lee, Byoung Chan ; Badawi, Nadia ; Mohammad, Shekeeb S ; Paget, Simon ; Dale, Russell C. ; Gill, Deepak ; Kothur, Kavitha ; Cerebral Palsy Alliance study group</creatorcontrib><description>Aim
To investigate clinicoradiological features associated with epilepsy, its resolution, and drug resistance in children with cerebral palsy (CP).
Method
Data were gathered from the New South Wales/Australian Capital Territory CP Register, encompassing children with CP born between 2003 and 2015 (n = 1916). Clinical features and the severity of impairments were compared among three groups: children with current epilepsy (n = 604), those with resolved epilepsy by age 5 years (n = 109), and those without epilepsy (n = 1203). Additionally, a subset of the registry cohort attending Children's Hospital Westmead (n = 256) was analysed to compare epilepsy and treatment characteristics between drug‐responsive (n = 83) and drug‐resistant groups (n = 147) using logistic regression and hierarchical cluster analysis.
Results
Manual Ability Classification System levels IV and V, intellectual impairment, and vision impairment were found to be associated with epilepsy in children with CP on multivariable analysis (p < 0.01). Moderate to severe intellectual impairment and bilateral spastic CP were independent positive and negative predictors of epilepsy persistence at the age of 5 years respectively (p < 0.05). Microcephaly and multiple seizure types were predictors of drug‐resistant epilepsy (area under the receiver operating characteristic curve of 0.83; 95% confidence interval 0.77–0.9). Children with a known genetic cause (14%) and CP epilepsy surgery group (4.3%) formed specific clinical subgroups in CP epilepsy.
Interpretation
Our study highlights important clinical associations of epilepsy, its resolution, and treatment response in children with CP, providing valuable knowledge to aid in counselling families and identifying distinct prognostic groups for effective medical surveillance and optimal treatment.
What this paper adds
Severe motor and non‐motor impairments in cerebral palsy (CP) increase epilepsy risk.
Epilepsy more likely resolves in bilateral spastic and milder CP impairments.
Epilepsy in CP often manifests at an early age with multiple seizure types and high drug resistance.
Children with a known genetic cause and CP epilepsy surgery group represent distinct clinical subgroups.
What this paper adds
Severe motor and non‐motor impairments in cerebral palsy (CP) increase epilepsy risk.
Epilepsy more likely resolves in bilateral spastic and milder CP impairments.
Epilepsy in CP often manifests at an early age with multiple seizure types and high drug resistance.
Children with a known genetic cause and CP epilepsy surgery group represent distinct clinical subgroups.
This original article is commented on by Ruggieri on pages 689–690 of this issue.</description><identifier>ISSN: 0012-1622</identifier><identifier>EISSN: 1469-8749</identifier><identifier>DOI: 10.1111/dmcn.15807</identifier><identifier>PMID: 38059324</identifier><language>eng</language><publisher>England</publisher><subject>Anticonvulsants - therapeutic use ; Cerebral Palsy - complications ; Child ; Child, Preschool ; Drug Resistance ; Drug Resistant Epilepsy - drug therapy ; Drug Resistant Epilepsy - genetics ; Epilepsy - drug therapy ; Female ; Humans ; Infant ; Intellectual Disability ; Male ; New South Wales - epidemiology ; Registries ; Severity of Illness Index ; Vision Disorders - etiology</subject><ispartof>Developmental medicine and child neurology, 2024-06, Vol.66 (6), p.793-803</ispartof><rights>2023 The Authors. published by John Wiley & Sons Ltd on behalf of Mac Keith Press.</rights><rights>2023 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3657-419dfd695188d0335357f229c05d8ee22c81fd73c9981b80380d98eb830a24913</citedby><cites>FETCH-LOGICAL-c3657-419dfd695188d0335357f229c05d8ee22c81fd73c9981b80380d98eb830a24913</cites><orcidid>0000-0002-2495-1826 ; 0000-0003-0099-0617 ; 0000-0002-0234-1541 ; 0000-0002-6219-9479 ; 0000-0003-1480-8409 ; 0000-0001-6436-4936 ; 0000-0002-0109-8877</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38059324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Feroze, Nimra</creatorcontrib><creatorcontrib>Karim, Tasneem</creatorcontrib><creatorcontrib>Ostojic, Katarina</creatorcontrib><creatorcontrib>Mcintyre, Sarah</creatorcontrib><creatorcontrib>Barnes, Elizabeth H.</creatorcontrib><creatorcontrib>Lee, Byoung Chan</creatorcontrib><creatorcontrib>Badawi, Nadia</creatorcontrib><creatorcontrib>Mohammad, Shekeeb S</creatorcontrib><creatorcontrib>Paget, Simon</creatorcontrib><creatorcontrib>Dale, Russell C.</creatorcontrib><creatorcontrib>Gill, Deepak</creatorcontrib><creatorcontrib>Kothur, Kavitha</creatorcontrib><creatorcontrib>Cerebral Palsy Alliance study group</creatorcontrib><title>Clinical features associated with epilepsy occurrence, resolution, and drug resistance in children with cerebral palsy: A population‐based study</title><title>Developmental medicine and child neurology</title><addtitle>Dev Med Child Neurol</addtitle><description>Aim
To investigate clinicoradiological features associated with epilepsy, its resolution, and drug resistance in children with cerebral palsy (CP).
Method
Data were gathered from the New South Wales/Australian Capital Territory CP Register, encompassing children with CP born between 2003 and 2015 (n = 1916). Clinical features and the severity of impairments were compared among three groups: children with current epilepsy (n = 604), those with resolved epilepsy by age 5 years (n = 109), and those without epilepsy (n = 1203). Additionally, a subset of the registry cohort attending Children's Hospital Westmead (n = 256) was analysed to compare epilepsy and treatment characteristics between drug‐responsive (n = 83) and drug‐resistant groups (n = 147) using logistic regression and hierarchical cluster analysis.
Results
Manual Ability Classification System levels IV and V, intellectual impairment, and vision impairment were found to be associated with epilepsy in children with CP on multivariable analysis (p < 0.01). Moderate to severe intellectual impairment and bilateral spastic CP were independent positive and negative predictors of epilepsy persistence at the age of 5 years respectively (p < 0.05). Microcephaly and multiple seizure types were predictors of drug‐resistant epilepsy (area under the receiver operating characteristic curve of 0.83; 95% confidence interval 0.77–0.9). Children with a known genetic cause (14%) and CP epilepsy surgery group (4.3%) formed specific clinical subgroups in CP epilepsy.
Interpretation
Our study highlights important clinical associations of epilepsy, its resolution, and treatment response in children with CP, providing valuable knowledge to aid in counselling families and identifying distinct prognostic groups for effective medical surveillance and optimal treatment.
What this paper adds
Severe motor and non‐motor impairments in cerebral palsy (CP) increase epilepsy risk.
Epilepsy more likely resolves in bilateral spastic and milder CP impairments.
Epilepsy in CP often manifests at an early age with multiple seizure types and high drug resistance.
Children with a known genetic cause and CP epilepsy surgery group represent distinct clinical subgroups.
What this paper adds
Severe motor and non‐motor impairments in cerebral palsy (CP) increase epilepsy risk.
Epilepsy more likely resolves in bilateral spastic and milder CP impairments.
Epilepsy in CP often manifests at an early age with multiple seizure types and high drug resistance.
Children with a known genetic cause and CP epilepsy surgery group represent distinct clinical subgroups.
This original article is commented on by Ruggieri on pages 689–690 of this issue.</description><subject>Anticonvulsants - therapeutic use</subject><subject>Cerebral Palsy - complications</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Drug Resistance</subject><subject>Drug Resistant Epilepsy - drug therapy</subject><subject>Drug Resistant Epilepsy - genetics</subject><subject>Epilepsy - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Intellectual Disability</subject><subject>Male</subject><subject>New South Wales - epidemiology</subject><subject>Registries</subject><subject>Severity of Illness Index</subject><subject>Vision Disorders - etiology</subject><issn>0012-1622</issn><issn>1469-8749</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp9kUtO5DAQhi0EggZmwwGQl2hEwI-kY7Nr9fCSYNgw68ixK-CRO8nYsVB2HAFxxDkJbgIsqU1JpU9fqepH6ICSE5rq1Kx0e0ILQcoNNKP5XGaizOUmmhFCWUbnjO2g3RD-EkL4vMi30Q4XpJCc5TP0unS2tVo53IAaooeAVQidtmoAg5_s8Iihtw76MOJO6-g9tBqOcQI7FwfbtcdYtQYbHx_WQxsGlQBsW6wfrTMJnywaPNQ-7emVC-MZXuC-66NTa8X_55dahbQvDNGM-2irSQz8-Oh76M_F-f3yKru5u7xeLm4yna4os5xK05i5LKgQhnBe8KJsGJOaFEYAMKYFbUzJtZSC1oKkm40UUAtOFMsl5XvoaPL2vvsXIQzVygYNzqkWuhgqJqTkJZFcJvTnhGrfheChqXpvV8qPFSXVOoNqnUH1nkGCDz-8sV6B-UI_n54AOgFP6bHjN6rq1-3y9yR9A9oelLE</recordid><startdate>202406</startdate><enddate>202406</enddate><creator>Feroze, Nimra</creator><creator>Karim, Tasneem</creator><creator>Ostojic, Katarina</creator><creator>Mcintyre, Sarah</creator><creator>Barnes, Elizabeth H.</creator><creator>Lee, Byoung Chan</creator><creator>Badawi, Nadia</creator><creator>Mohammad, Shekeeb S</creator><creator>Paget, Simon</creator><creator>Dale, Russell C.</creator><creator>Gill, Deepak</creator><creator>Kothur, Kavitha</creator><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2495-1826</orcidid><orcidid>https://orcid.org/0000-0003-0099-0617</orcidid><orcidid>https://orcid.org/0000-0002-0234-1541</orcidid><orcidid>https://orcid.org/0000-0002-6219-9479</orcidid><orcidid>https://orcid.org/0000-0003-1480-8409</orcidid><orcidid>https://orcid.org/0000-0001-6436-4936</orcidid><orcidid>https://orcid.org/0000-0002-0109-8877</orcidid></search><sort><creationdate>202406</creationdate><title>Clinical features associated with epilepsy occurrence, resolution, and drug resistance in children with cerebral palsy: A population‐based study</title><author>Feroze, Nimra ; Karim, Tasneem ; Ostojic, Katarina ; Mcintyre, Sarah ; Barnes, Elizabeth H. ; Lee, Byoung Chan ; Badawi, Nadia ; Mohammad, Shekeeb S ; Paget, Simon ; Dale, Russell C. ; Gill, Deepak ; Kothur, Kavitha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3657-419dfd695188d0335357f229c05d8ee22c81fd73c9981b80380d98eb830a24913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Anticonvulsants - therapeutic use</topic><topic>Cerebral Palsy - complications</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Drug Resistance</topic><topic>Drug Resistant Epilepsy - drug therapy</topic><topic>Drug Resistant Epilepsy - genetics</topic><topic>Epilepsy - drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Intellectual Disability</topic><topic>Male</topic><topic>New South Wales - epidemiology</topic><topic>Registries</topic><topic>Severity of Illness Index</topic><topic>Vision Disorders - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Feroze, Nimra</creatorcontrib><creatorcontrib>Karim, Tasneem</creatorcontrib><creatorcontrib>Ostojic, Katarina</creatorcontrib><creatorcontrib>Mcintyre, Sarah</creatorcontrib><creatorcontrib>Barnes, Elizabeth H.</creatorcontrib><creatorcontrib>Lee, Byoung Chan</creatorcontrib><creatorcontrib>Badawi, Nadia</creatorcontrib><creatorcontrib>Mohammad, Shekeeb S</creatorcontrib><creatorcontrib>Paget, Simon</creatorcontrib><creatorcontrib>Dale, Russell C.</creatorcontrib><creatorcontrib>Gill, Deepak</creatorcontrib><creatorcontrib>Kothur, Kavitha</creatorcontrib><creatorcontrib>Cerebral Palsy Alliance study group</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Developmental medicine and child neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feroze, Nimra</au><au>Karim, Tasneem</au><au>Ostojic, Katarina</au><au>Mcintyre, Sarah</au><au>Barnes, Elizabeth H.</au><au>Lee, Byoung Chan</au><au>Badawi, Nadia</au><au>Mohammad, Shekeeb S</au><au>Paget, Simon</au><au>Dale, Russell C.</au><au>Gill, Deepak</au><au>Kothur, Kavitha</au><aucorp>Cerebral Palsy Alliance study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical features associated with epilepsy occurrence, resolution, and drug resistance in children with cerebral palsy: A population‐based study</atitle><jtitle>Developmental medicine and child neurology</jtitle><addtitle>Dev Med Child Neurol</addtitle><date>2024-06</date><risdate>2024</risdate><volume>66</volume><issue>6</issue><spage>793</spage><epage>803</epage><pages>793-803</pages><issn>0012-1622</issn><eissn>1469-8749</eissn><abstract>Aim
To investigate clinicoradiological features associated with epilepsy, its resolution, and drug resistance in children with cerebral palsy (CP).
Method
Data were gathered from the New South Wales/Australian Capital Territory CP Register, encompassing children with CP born between 2003 and 2015 (n = 1916). Clinical features and the severity of impairments were compared among three groups: children with current epilepsy (n = 604), those with resolved epilepsy by age 5 years (n = 109), and those without epilepsy (n = 1203). Additionally, a subset of the registry cohort attending Children's Hospital Westmead (n = 256) was analysed to compare epilepsy and treatment characteristics between drug‐responsive (n = 83) and drug‐resistant groups (n = 147) using logistic regression and hierarchical cluster analysis.
Results
Manual Ability Classification System levels IV and V, intellectual impairment, and vision impairment were found to be associated with epilepsy in children with CP on multivariable analysis (p < 0.01). Moderate to severe intellectual impairment and bilateral spastic CP were independent positive and negative predictors of epilepsy persistence at the age of 5 years respectively (p < 0.05). Microcephaly and multiple seizure types were predictors of drug‐resistant epilepsy (area under the receiver operating characteristic curve of 0.83; 95% confidence interval 0.77–0.9). Children with a known genetic cause (14%) and CP epilepsy surgery group (4.3%) formed specific clinical subgroups in CP epilepsy.
Interpretation
Our study highlights important clinical associations of epilepsy, its resolution, and treatment response in children with CP, providing valuable knowledge to aid in counselling families and identifying distinct prognostic groups for effective medical surveillance and optimal treatment.
What this paper adds
Severe motor and non‐motor impairments in cerebral palsy (CP) increase epilepsy risk.
Epilepsy more likely resolves in bilateral spastic and milder CP impairments.
Epilepsy in CP often manifests at an early age with multiple seizure types and high drug resistance.
Children with a known genetic cause and CP epilepsy surgery group represent distinct clinical subgroups.
What this paper adds
Severe motor and non‐motor impairments in cerebral palsy (CP) increase epilepsy risk.
Epilepsy more likely resolves in bilateral spastic and milder CP impairments.
Epilepsy in CP often manifests at an early age with multiple seizure types and high drug resistance.
Children with a known genetic cause and CP epilepsy surgery group represent distinct clinical subgroups.
This original article is commented on by Ruggieri on pages 689–690 of this issue.</abstract><cop>England</cop><pmid>38059324</pmid><doi>10.1111/dmcn.15807</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2495-1826</orcidid><orcidid>https://orcid.org/0000-0003-0099-0617</orcidid><orcidid>https://orcid.org/0000-0002-0234-1541</orcidid><orcidid>https://orcid.org/0000-0002-6219-9479</orcidid><orcidid>https://orcid.org/0000-0003-1480-8409</orcidid><orcidid>https://orcid.org/0000-0001-6436-4936</orcidid><orcidid>https://orcid.org/0000-0002-0109-8877</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0012-1622 |
| ispartof | Developmental medicine and child neurology, 2024-06, Vol.66 (6), p.793-803 |
| issn | 0012-1622 1469-8749 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2899370939 |
| source | Wiley |
| subjects | Anticonvulsants - therapeutic use Cerebral Palsy - complications Child Child, Preschool Drug Resistance Drug Resistant Epilepsy - drug therapy Drug Resistant Epilepsy - genetics Epilepsy - drug therapy Female Humans Infant Intellectual Disability Male New South Wales - epidemiology Registries Severity of Illness Index Vision Disorders - etiology |
| title | Clinical features associated with epilepsy occurrence, resolution, and drug resistance in children with cerebral palsy: A population‐based study |
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