Body mass index measures in children with cerebral palsy related to gross motor function classification: A clinic-based study

OBJECTIVE: To investigate the prevalence of overweight in a clinic-based population of children with cerebral palsy (CP) and its association with gross motor function status. DESIGN: Retrospective chart review. We calculated body mass index (BMI; kg/m) from charted height and weight and recorded Gross Motor Function Classification Scale (GMFCS levels I-V) on the basis of clinical descriptions in clinic notes for 137 children (2-18 yrs old) with CP seen in a pediatric rehabilitation clinic at an academic medical center. BMI percentiles were reported according to sex-specific age group standards for growth set by the U.S. Centers for Disease Control and Prevention (CDC). Associations were modeled by Pearson's χ distribution. RESULTS: Out of the total CP subject group, 29.1% were considered overweight (>95th percentile) or at risk for overweight (85th to 95th percentile). Ambulatory children (GMFCS levels I and II) showed a trend (Pearson's χ, P = 0.06) toward higher prevalence of overweight (22.7%) compared with nonambulatory children (levels IV and V, 9.6%). Underweight was more prevalent in nonambulatory children (P < 0.01). Logistic regression analysis did not identify any significant predictors for overweight. CONCLUSIONS: In our patient population, analysis of BMI suggests that children with CP have a high rate of overweight and are at risk of overweight, particularly among ambulatory children. More study is needed, using measures more accurate than BMI, to clarify risk.