Weight measurements and disease-specific growth charts to predict clinical outcomes in children with cerebral palsy
Developmental Medicine & Child Neurology, Judy-April O. Murayi, Laurie J. Glader, Richard D. Stevenson, Carson J. Richardson, Praveen S. Goday
February 28, 2026
Aim
To determine whether weight-for-age (WFA) centiles on disease-specific growth charts predict clinical outcomes in children with cerebral palsy (CP).
Method
We conducted a retrospective cohort study of pediatric patients with CP in Gross Motor Function Classification System levels III to V, treated at a tertiary care hospital from January 2016 to June 2022. Patients were categorized as above or below the 20th centile WFA using CP-specific growth curves. Clinical outcomes included emergency department and urgent care visits, hospital and pediatric intensive care unit (PICU) admissions, fracture incidence, surgical procedures, and mortality.
Results
Of 127 patients (62.9% male, age range at study entry 3–20 years; mean age 10 years 7 months, SD 4 years 5 months), 113 were above and 14 were below the 20th centile. The ‘below’ group had a 122% higher mean number of emergency department and urgent care visits than the ‘above’ group (p = 0.004, adjusted incidence rate ratio: 2.22; 95% confidence interval: 1.29, 3.8). They also had a median 1.5 more PICU admissions and 5.2 longer PICU days compared to the ‘above’ group. Mortality was 4.4% (5/113) in the ‘above’ group and 28.6% (4/14) in the ‘below’ group.
Interpretation
Children with CP who fall below the 20th centile WFA appear to require more healthcare services and may face increased mortality risk. Maintaining WFA above the 20th centile may represent an important clinical target.
Graphical Abstract
This was a retrospective cohort study of pediatric patients with cerebral palsy (CP), Gross Motor Function Classification System (GMFCS) levels III to V, treated at a tertiary care hospital between January 2016 and June 2022. The cohort was grouped into patients above and below the 20th centile weight-for-age on CP-specific growth curves. We found that underweight pediatric patients with CP (GMFCS levels III–V) are at increased risk for requiring more healthcare services and potentially increased mortality.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflict of interest.
DATA AVAILABILITY STATEMENT
The authors will provide underlying data upon reasonable request.
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