Fracture Rates in Children with Cerebral Palsy: A Danish, Nationwide Register-Based Study

Jakob Bie Granild-Jensen; Alma Becic Pedersen; Eskild Bendix Kristiansen; Bente Langdahl; Bjarne Møller-Madsen; Charlotte Søndergaard; Stense Farholt; Esben Thyssen Vestergaard; Gija Rackauskaite

doi:10.2147/CLEP.S381343

Fracture Rates in Children with Cerebral Palsy: A Danish, Nationwide Register-Based Study

Jakob Bie Granild-Jensen^*, Alma Becic Pedersen, Eskild Bendix Kristiansen, Bente Langdahl, Bjarne Møller-Madsen, Charlotte Søndergaard, Stense Farholt, Esben Thyssen Vestergaard, Gija Rackauskaite

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

5 Citations (Scopus)

Abstract

BACKGROUND: In children with cerebral palsy (CP), fracture rates have been reported to be higher than in the general population but age-specific fracture rates have not been directly compared and the effect of comorbid epilepsy needs elucidation. This impairs decision-making regarding bone health interventions.

AIM: We aimed to establish the age-specific fracture rates in children with CP with and without epilepsy in Denmark.

MATERIALS AND METHODS: Data from Danish registers were combined to establish cohorts of children with and without CP born in Denmark from 1997 to 2007. Fracture rates were calculated for 1997-2016.

RESULTS: We identified 1,451 children with CP and 787,159 without CP. Female/male fracture rates per 1,000 person-years were 23/27 with CP and 23/29 without CP. Male sex, epilepsy and anti-seizure medication, but not the diagnosis of CP or GMFCS-level, were associated with higher fracture rates. Relatively more lower extremity fractures occurred in non-ambulant children with CP.

INTERPRETATION/CONCLUSION: We found no increased fracture rates in children with CP when compared to peers; however, fracture locations suggested bone fragility in non-ambulant children. All children with epilepsy and on anti-seizure medication had increased fracture rates. We suggest bone health optimization in these groups.

Original language	English
Journal	Clinical epidemiology
Volume	14
Pages (from-to)	1405-1414
Number of pages	10
ISSN	1179-1349
DOIs	https://doi.org/10.2147/CLEP.S381343
Publication status	Published - Nov 2022

Keywords

anti-seizure medication
cerebral palsy
children
epilepsy
fracture rate
Gross Motor Classification System

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10.2147/CLEP.S381343Licence: CC BY-NC

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9700470/pdf/clep-14-1405.pdf

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@article{45f34b3248fc448b8d7fff3aab4d3175,

title = "Fracture Rates in Children with Cerebral Palsy: A Danish, Nationwide Register-Based Study",

abstract = "BACKGROUND: In children with cerebral palsy (CP), fracture rates have been reported to be higher than in the general population but age-specific fracture rates have not been directly compared and the effect of comorbid epilepsy needs elucidation. This impairs decision-making regarding bone health interventions.AIM: We aimed to establish the age-specific fracture rates in children with CP with and without epilepsy in Denmark.MATERIALS AND METHODS: Data from Danish registers were combined to establish cohorts of children with and without CP born in Denmark from 1997 to 2007. Fracture rates were calculated for 1997-2016.RESULTS: We identified 1,451 children with CP and 787,159 without CP. Female/male fracture rates per 1,000 person-years were 23/27 with CP and 23/29 without CP. Male sex, epilepsy and anti-seizure medication, but not the diagnosis of CP or GMFCS-level, were associated with higher fracture rates. Relatively more lower extremity fractures occurred in non-ambulant children with CP.INTERPRETATION/CONCLUSION: We found no increased fracture rates in children with CP when compared to peers; however, fracture locations suggested bone fragility in non-ambulant children. All children with epilepsy and on anti-seizure medication had increased fracture rates. We suggest bone health optimization in these groups.",

keywords = "knoglesk{\o}rhed, osteoporose, b{\o}rn, knoglebrud, fraktur, epilepsi, anti seizure medication, anti-seizure medication, cerebral palsy, children, epilepsy, fracture rate, Gross Motor Classification System",

author = "Granild-Jensen, {Jakob Bie} and Pedersen, {Alma Becic} and Kristiansen, {Eskild Bendix} and Bente Langdahl and Bjarne M{\o}ller-Madsen and Charlotte S{\o}ndergaard and Stense Farholt and Vestergaard, {Esben Thyssen} and Gija Rackauskaite",

note = "{\textcopyright} 2022 Granild-Jensen et al.",

year = "2022",

month = nov,

doi = "10.2147/CLEP.S381343",

language = "English",

volume = "14",

pages = "1405--1414",

journal = "Clinical epidemiology",

issn = "1179-1349",

publisher = "Dove Medical Press Ltd.",

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Fracture Rates in Children with Cerebral Palsy: A Danish, Nationwide Register-Based Study. / Granild-Jensen, Jakob Bie ; Pedersen, Alma Becic ; Kristiansen, Eskild Bendix et al.
In: Clinical epidemiology, Vol. 14, 11.2022, p. 1405-1414.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Fracture Rates in Children with Cerebral Palsy: A Danish, Nationwide Register-Based Study

AU - Granild-Jensen, Jakob Bie

AU - Pedersen, Alma Becic

AU - Kristiansen, Eskild Bendix

AU - Langdahl, Bente

AU - Møller-Madsen, Bjarne

AU - Søndergaard, Charlotte

AU - Farholt, Stense

AU - Vestergaard, Esben Thyssen

AU - Rackauskaite, Gija

PY - 2022/11

Y1 - 2022/11

N2 - BACKGROUND: In children with cerebral palsy (CP), fracture rates have been reported to be higher than in the general population but age-specific fracture rates have not been directly compared and the effect of comorbid epilepsy needs elucidation. This impairs decision-making regarding bone health interventions.AIM: We aimed to establish the age-specific fracture rates in children with CP with and without epilepsy in Denmark.MATERIALS AND METHODS: Data from Danish registers were combined to establish cohorts of children with and without CP born in Denmark from 1997 to 2007. Fracture rates were calculated for 1997-2016.RESULTS: We identified 1,451 children with CP and 787,159 without CP. Female/male fracture rates per 1,000 person-years were 23/27 with CP and 23/29 without CP. Male sex, epilepsy and anti-seizure medication, but not the diagnosis of CP or GMFCS-level, were associated with higher fracture rates. Relatively more lower extremity fractures occurred in non-ambulant children with CP.INTERPRETATION/CONCLUSION: We found no increased fracture rates in children with CP when compared to peers; however, fracture locations suggested bone fragility in non-ambulant children. All children with epilepsy and on anti-seizure medication had increased fracture rates. We suggest bone health optimization in these groups.

AB - BACKGROUND: In children with cerebral palsy (CP), fracture rates have been reported to be higher than in the general population but age-specific fracture rates have not been directly compared and the effect of comorbid epilepsy needs elucidation. This impairs decision-making regarding bone health interventions.AIM: We aimed to establish the age-specific fracture rates in children with CP with and without epilepsy in Denmark.MATERIALS AND METHODS: Data from Danish registers were combined to establish cohorts of children with and without CP born in Denmark from 1997 to 2007. Fracture rates were calculated for 1997-2016.RESULTS: We identified 1,451 children with CP and 787,159 without CP. Female/male fracture rates per 1,000 person-years were 23/27 with CP and 23/29 without CP. Male sex, epilepsy and anti-seizure medication, but not the diagnosis of CP or GMFCS-level, were associated with higher fracture rates. Relatively more lower extremity fractures occurred in non-ambulant children with CP.INTERPRETATION/CONCLUSION: We found no increased fracture rates in children with CP when compared to peers; however, fracture locations suggested bone fragility in non-ambulant children. All children with epilepsy and on anti-seizure medication had increased fracture rates. We suggest bone health optimization in these groups.

KW - knogleskørhed, osteoporose, børn, knoglebrud, fraktur, epilepsi, anti seizure medication

KW - anti-seizure medication

KW - cerebral palsy

KW - children

KW - epilepsy

KW - fracture rate

KW - Gross Motor Classification System

U2 - 10.2147/CLEP.S381343

DO - 10.2147/CLEP.S381343

M3 - Journal article

C2 - 36444291

SN - 1179-1349

VL - 14

SP - 1405

EP - 1414

JO - Clinical epidemiology

JF - Clinical epidemiology

ER -

Fracture Rates in Children with Cerebral Palsy: A Danish, Nationwide Register-Based Study

Abstract

Keywords

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