Eating and drinking abilities and respiratory and oral health in children and young adults with cerebral palsy.

Abstract

Aim: To investigate the potential risk factors of respiratory illness (ethnicity, oral health, and eating and drinking ability) in children and young adults with cerebral palsy (CP).

Method: This was an observational study using a validated CP Respiratory and Oral Health questionnaire with 90 participants (median age 12 years [range: 1-26 years]; 51 males; and 26 New Zealand Māori).

Results: Multivariate analysis, accounting for ethnicity and Gross Motor Function Classification System (GMFCS) levels, showed that those participants who were classified in Eating and Drinking Ability Classification System (EDACS) levels III to V reported more previous respiratory disease episodes (odds ratio [OR] = 4.13, 95% confidence interval [CI] = 1.12-15.2, p = 0.033), increased daily/weekly respiratory symptoms (OR = 9.14, 95% CI = 2.03-41.2, p = 0.004), and increased mealtime respiratory symptoms (OR = 13.8, 95% CI = 2.48-76.8, p = 0.002). Both EDACS levels III to V and GMFCS levels IV and V were independently associated with increased propensity to reflux or seizures (OR = 8.16, 95% CI = 1.77-37.5, p = 0.007; OR = 3.37, 95% CI = 1.09-10.4, p < 0.034). Mealtime symptoms of vomiting or regurgitation (relative risk = 1.58, 95% CI = 1.17-2.13, p = 0.032) and daily coughing (relative risk = 1.55, 95% CI = 1.14-2.11, p = 0.023) were associated with a higher risk of reporting one or more oral health symptoms. Toothache was more common in participants classified in EDACS levels III to V (χ², p = 0.021).

Interpretation: Children with CP classified in EDACS levels III to V are at a higher risk of respiratory disease and toothache and should be screened appropriately. Regurgitation or vomiting of food and daily coughing are linked with poorer oral health.