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Malnutrition and nutritional deficiencies in children with cerebral palsy: a systematic review and meta-analysis
D C G da Silva1, M de Sá Barreto da Cunha1, A de Oliveira Santana1
1Universidade Federal do Oeste da Bahia, Barreiras, Bahia, Brazil.
Insights
Malnutrition affects 40% of children with cerebral palsy (CP), with common deficiencies including calcium, zinc, copper, and vitamin D. Personalized nutritional monitoring is crucial for these children.
Area of Science:
- Pediatrics
- Nutrition Science
- Public Health
Background:
- Cerebral palsy (CP) is a complex neurological disorder affecting motor function.
- Nutritional status in children with CP is often compromised, impacting growth and development.
- Understanding the prevalence of malnutrition and deficiencies is vital for effective management.
Purpose of the Study:
- To systematically review and meta-analyze the prevalence of malnutrition and specific nutritional deficiencies in children with CP.
- To synthesize existing evidence on the nutritional status of pediatric CP population.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Comprehensive literature search across multiple databases (PubMed, Embase, Scopus, etc.).
- Inclusion of studies on children aged 0-18 with CP, assessing malnutrition and nutritional deficiencies; methodological quality assessed using established tools.
Main Results:
- Included 67 articles (N=453,804) published between 1986 and 2019.
- Estimated prevalence of malnutrition in children with CP was 40% (95% CI: 28.0-53.0).
- Common deficiencies included hypocalcemia, and reduced serum concentrations of zinc, copper, and vitamin D.
Conclusions:
- High rates of malnutrition observed in children with CP.
- Nutritional deficiencies are linked to food deficits, socio-economic status, and age.
- Personalized nutritional monitoring and management are essential for children with CP.
Objectives:
This systematic review study and meta-analysis sought to estimate the prevalence of malnutrition and nutritional deficiencies in children with cerebral palsy (CP).
Study Design:
This is a systematic review and meta-analysis.
Methods:
The systematic review was conducted according to the PRISMA guidelines. The articles were chosen using the PubMed, Embase, Scopus, Web of Science, Cochrane Library, SciELO, and Lilacs databases and the bibliographical reference lists of the articles. No limitations were placed on the time of publication, but the articles had to include children from 0 to 18 years old with CP who presented the prevalence of malnutrition and nutritional deficiencies. The methodological quality of the articles was assessed using the verification list for analytical cross-sectional studies, the Newcastle-Ottawa scale, and the Cochrane Collaboration tool for randomized studies. The meta-analysis of proportions was conducted based on the prevalence data for malnutrition or nutritional deficiencies. The study is registered in PROSPERO under CRD number 42020175068.
Results:
Sixty-seven articles (N = 453,804) published between 1986 and 2019 were included. Most of the articles presented a low risk of bias and no publication was excluded for quality reasons. The most widely used anthropometric index for diagnosing nutritional status was weight-to-age and the estimated prevalence of malnutrition was 40% (95% CI = 28.0-53.0). Nutrient deficiency was investigated by nine publications, with hypocalcemia and reduced serum concentrations of zinc, copper, and vitamin D being reported the most.
Conclusions:
We found a high rate of malnutrition in the population in this review, moreover, we suggest that some nutritional deficiencies are associated with food deficit and that the socio-economic and age factors of these children may relate with the poor nutritional outcome. This makes monitoring and personalized nutritional management necessary, in accordance with the characteristics and particularities of children with CP.
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