Investigating the association between maternal age and cerebral palsy incidence: A meta-analysis

Cerebral palsy (CP) is a group of nonprogressive motor and postural disorders resulting from early developmental brain injury. While maternal age is a known factor associated with CP risk, previous studies have shown inconsistent findings, particularly regarding advanced maternal age. In addition, earlier meta-analyses often lack stratification by gestational age or do not include recent population-based studies. This meta-analysis aims to provide an updated and more detailed assessment of the association between maternal age at delivery and the risk of CP, using refined age group classifications and subgroup analyses based on gestational age.

We systematically searched the Embase, PubMed & Medline databases (from inception to March 2024) for English publications; we searched for all published studies comparing the number of cases (CP) and the number of controls according to maternal age. A meta-analysis was performed using R Statistical Software version 4.2.2 (The R Foundation for Statistical Computing). The odds of CP were examined among the maternal ages at delivery of 18 years old or younger, 25 years old or younger, 35 years old or older, or 40 years old or older, with a positive log odds ratio (OR) indicating higher odds of CP.

From 9237 initially identified articles, 12 studies were ultimately included. Young maternal age (≤18 years old) was found to significantly increase the risk of CP (OR = 0.1374, P < .0001). The maternal groups defined by the ages of 25 and 35 years showed mixed risks, with term infants from mothers aged 35 years and older having higher odds of CP (OR = 0.9198, P = .0023).

CP risk is higher in children born to mothers aged 18 years or younger and may also increase in full-term births to mothers aged 35 years or older. These findings may help guide risk assessment and public health planning.