Serum micronutrient profiles and clinical correlates in children with cerebral palsy: A comprehensive evaluation

Abstract

Aim: The increasing prevalence of pediatric cerebral palsy (CP) underscores the critical role of micronutrients. This study aimed to investigate the relationship between clinical characteristics and micronutrient levels in CP.

Methods: In this retrospective, single-center study, data from 234 children aged 0–18 years with CP between January 2020-2025 were analyzed. Demographics, the Gross Motor Function Classification System Score (GMFCSS), comorbidities, hospitalization and pediatric intensive care unit (PICU) admissions, respiratory support, nutritional status, and infection history were evaluated. Serum levels of vitamin D, vitamin B12, folic acid, ferritin, and albumin were compared with these clinical variables.

Results: 234 children were included, with a mean age of 126.15±54.26 months. Spastic quadriplegia was the most common subtype (49.6%), and 46.6% of the cohort were classified as GMFCSS IV–V. Hospitalization history was present in 45.3%, 15.4% had PICU admission, and 64.1% experienced at least one infection in the past year. Hospitalization frequency correlated positively with vitamin B12 (r=0.194, p=0.003) and ferritin (r=0.198, p=0.002). Serum albumin was significantly lower in requiring respiratory support (p=0.016) and differed by feeding modality (p=0.031). Vitamin D levels varied only with the use of enteral nutrition products (p=0.010). Vitamin B12 levels were significantly higher in hospitalized patients, those with PICU admission, those receiving respiratory support, and users of enteral nutrition products (p<0.05).

Conclusion: The findings indicate that micronutrient status remains closely linked to clinical severity in CP. In particular, elevated vitamin B12 and ferritin correlated with higher GMFCSS, likely reflecting increased healthcare needs and supplementation practices among more severely affected.