Onset factors in cerebral palsy: A systematic review

- Cerebral Palsy (CP) is a group of heterogeneous non-progressive neurodevelopmental conditions that affect the developing fetal or infant brain.
- These conditions may occur in utero, at birth, or during the first three years of life when the brain is developing.
- The worldwide prevalence rate of CP is 2.11 per 1000 live births.
- Following risk factors were found to be associated with the onset of CP-late preterm gestation age, primparity, low birth weight, and a low APGAR score, low arterial cord pH, clinical chorioamnionitis, multiple gestation/births.

Studies have noted several factors associated with the occurrence of Cerebral Palsy (CP), yet considerable uncertainty remains about modifiable factors related to disease onset. A systematic review was performed to identify existing systematic reviews and primary studies pertaining to targeted factors associated with the onset of CP. The following databases were searched: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Scopus, Web of Science, Cochrane Database of Systematic Reviews, CINHAL, ProQuest Dissertations & Theses, Huge Navigator, AARP Ageline. Variations of MeSH and keyword search terms were used. Critical appraisal was conducted on selected articles. Data extraction targeted reported factors, risk estimates, and 95% confidence intervals (CI). Findings identified two systematic reviews and three meta- analyses, as well as 83 studies of case control, cohort, and cross-sectional methodological designs. Selected studies indicated that lower gestational age was associated with the onset of CP. Medical diagnoses for the mother, in particular chorioamnionitis, was found to be positively associated with onset of CP. Preeclampsia was reported to be either inconclusive or positively associated with CP onset. Low birth weight predominantly indicated a positive association with the onset of CP, while male gender showed mixed findings. The combination of male gender with pre-term or low birth weight was also found to be positively associated with CP. Evidence was identified in the literature pertaining to specific factors relating to the onset of CP, in particular showing positive associations with lower gestational age and low birth weight.