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Risk factors of cerebral palsy in children: a systematic review and meta-analysis
Dandan Chen1, Meiyuan Huang2, Yangyan Yin1
1Department of Pediatrics, the First Affiliated Hospital of Hainan Medical University, Haikou, China.
Insights
Key risk factors for cerebral palsy in children include maternal hypertension, premature rupture of membranes, preterm birth, and emergency cesarean sections. This meta-analysis highlights crucial elements for monitoring and intervention strategies.
Area of Science:
- Pediatrics
- Obstetrics
- Epidemiology
Background:
- Cerebral palsy (CP) is a complex neurological disorder affecting child development.
- Identifying modifiable risk factors is crucial for prevention and early intervention.
- Existing literature on CP risk factors requires comprehensive synthesis.
Purpose of the Study:
- To systematically identify and analyze the primary risk factors associated with cerebral palsy in children.
- To provide an evidence-based reference for healthcare professionals and researchers.
- To inform public health strategies aimed at reducing the incidence of cerebral palsy.
Main Methods:
- A meta-analysis was conducted on case-control and cohort studies retrieved from PubMed, EMBASE, Medline, and CENTRAL.
- Studies were assessed for quality using the Newcastle-Ottawa Scale (NOS).
- Heterogeneity and publication bias were evaluated using Chi-square tests, Egger's test, and subgroup/sensitivity analyses.
Main Results:
- Thirteen studies involving 2,489 children with cerebral palsy and 4,782 controls were included.
- Maternal hypertension during pregnancy, premature rupture of membranes, premature delivery, and emergency cesarean section were identified as significant risk factors.
- No significant heterogeneity or publication bias was detected among the included studies.
Conclusions:
- Gestational hypertension, preterm birth, premature rupture of membranes, and emergency cesarean section are confirmed risk factors for cerebral palsy.
- Findings offer valuable insights for risk monitoring and clinical management of cerebral palsy.
- This meta-analysis provides a robust foundation for future research and preventative measures.
Background:
This study aimed to explore the main risk factors for cerebral palsy in children by meta-analysis of the literature on the risk factors of cerebral palsy.
Methods:
We performed a literature search of the PubMed, EMBASE, Medline, and CENTRAL databases using the following search terms: ("cerebrl plsy" or "cerebrl plsis" or "infantile cerebral palsy") and ("risk factors"). Case-control or cohort studies of children with cerebral palsy and healthy children were included for meta-analysis. The Newcastle-Ottawa Scale (NOS) of case-control studies was used to evaluate the quality of the included studies. The Chi-square test was used to test the heterogeneity of the literature. This study used subgroup analysis and sensitivity analysis to identify sources of heterogeneity. If subgroup analyses and sensitivity analyses could not identify the source of heterogeneity, no pooling between study results was performed, and only individual study results were described. In this study, Egger's test was used to test for publication bias. The random-effects model was used when heterogeneity existed, and the fixed-effect model was applied when heterogeneity did not exist.
Results:
A total of 1,836 related articles were retrieved. After screening, 13 articles were included in the analysis, involving a total of 2,489 children with cerebral palsy and 4,782 children without cerebral palsy. None of the included articles achieved a NOS score of 9, four articles scored 8, eight articles scored 7, and one article scored 6. Meta-analysis showed that maternal hypertension during pregnancy, premature rupture of membranes, premature delivery and emergency cesarean section were risk factors for cerebral palsy in children, and there was no heterogeneity among the literatures and no publication bias.
Conclusions:
This study identified gestational hypertension, preterm birth, premature rupture of membranes, and emergency cesarean section as risk factors for cerebral palsy in children through meta-analysis, providing a reference for risk monitoring and clinical intervention.
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