Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;11(4):556-564.
doi: 10.21037/tp-22-78.

Risk factors of cerebral palsy in children: a systematic review and meta-analysis

Dandan Chen #  1 , Meiyuan Huang #  2 , Yangyan Yin  1 , Dongmei Gui  1 , Yuniao Gu  2 , Taiping Zhuang  2 , Caihua Chen  2 , Kaiming Huo  3
Affiliations

Risk factors of cerebral palsy in children: a systematic review and meta-analysis

Dandan Chen et al. Transl Pediatr. 2022 Apr.

Abstract

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.

Keywords: Children; cerebral palsy; risk factors.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-22-78/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Literature screening flow chart.
Figure 2
Figure 2
Forest map of maternal pregnancy-induced hypertension and cerebral palsy in children. CI, confidence interval; SE, standard error.
Figure 3
Figure 3
Funnel diagram of maternal pregnancy-induced hypertension and cerebral palsy in children. OR, odds ratio.
Figure 4
Figure 4
Forest map of premature rupture of membranes and cerebral palsy in children. CI, confidence interval; SE, standard error.
Figure 5
Figure 5
Funnel diagram of premature rupture of membranes and cerebral palsy in children. OR, odds ratio.
Figure 6
Figure 6
Forest map of premature birth and cerebral palsy in children. CI, confidence interval; SE, standard error.
Figure 7
Figure 7
Funnel diagram of preterm birth and cerebral palsy in children. OR, odds ratio.
Figure 8
Figure 8
Emergency cesarean section and forest map of cerebral palsy in children. CI, confidence interval; SE, standard error.
Figure 9
Figure 9
Funnel diagram of emergency cesarean section and cerebral palsy in children. OR, odds ratio.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Yuan J, Wang J, Ma J, et al. Paediatric cerebral palsy prevalence and high-risk factors in Henan province, Central China. J Rehabil Med 2019;51:47-53. 10.2340/16501977-2486 - DOI - PubMed
    1. Toldi J, Escobar J, Brown A. Cerebral Palsy: Sport and Exercise Considerations. Curr Sports Med Rep 2021;20:19-25. 10.1249/JSR.0000000000000798 - DOI - PubMed
    1. Livinec F, Ancel PY, Marret S, et al. Prenatal risk factors for cerebral palsy in very preterm singletons and twins. Obstet Gynecol 2005;105:1341-7. 10.1097/01.AOG.0000161375.55172.3f - DOI - PubMed
    1. Drougia A, Giapros V, Krallis N, et al. Incidence and risk factors for cerebral palsy in infants with perinatal problems: a 15-year review. Early Hum Dev 2007;83:541-7. 10.1016/j.earlhumdev.2006.10.004 - DOI - PubMed
    1. Walstab JE, Bell RJ, Reddihough DS, et al. Factors identified during the neonatal period associated with risk of cerebral palsy. Aust N Z J Obstet Gynaecol 2004;44:342-6. 10.1111/j.1479-828X.2004.00249.x - DOI - PubMed