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Table 1 Hypothesized risk factors of pulmonary disease in children with neurological impairment / intellectual disabilities

From: A population-based nested case control study on recurrent pneumonias in children with severe generalized cerebral palsy: ethical considerations of the design and representativeness of the study sample

recurrent aspiration (dysphagia, gastro-oesophageal reflux) [14-16, 20, 28, 53, 54]
inefficient cough / poor cough reflex [14, 15, 28]
poor airway clearance (immobility and retained secretions) [14, 15]
respiratory muscle weakness and in-coordination [14, 15, 28]
chest wall or spinal deformities (poor pulmonary reserve) [14, 15, 28]
inadequate nutritional status (feeding problems, gastro-oesophageal reflux) [14, 15]
miscellaneous factors [2, 8, 10, 14-17]
bronchopulmonary dysplasia in preterm survivors
immune problems (Down's syndrome)
lipid aspiration in mineral oil treatment of constipation
reduced lung growth in skeletal dysplasias
normal childhood factors (e.g. asthma, passive smoking) [14, 15]
immobility [3, 10, 27, 28, 55, 56]