Universidade Federal do Oeste da Bahia, Barreiras, Bahia, Brazil.
Universidade Federal da Bahia, Salvador, Brazil.
Public Health. 2022 Apr;205:192-201. doi: 10.1016/j.puhe.2022.01.024. Epub 2022 Mar 24.
This systematic review study and meta-analysis sought to estimate the prevalence of malnutrition and nutritional deficiencies in children with cerebral palsy (CP).
This is a systematic review and meta-analysis.
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.
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.
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.
本系统评价研究和荟萃分析旨在估计脑瘫（CP）儿童营养不良和营养缺乏的患病率。
这是一项系统评价和荟萃分析。
系统评价按照 PRISMA 指南进行。使用 PubMed、Embase、Scopus、Web of Science、Cochrane 图书馆、SciELO 和 Lilacs 数据库以及文章的参考文献列表选择文章。未对出版时间进行限制，但文章必须包括 0 至 18 岁患有 CP 且存在营养不良和营养缺乏患病率的儿童。使用分析性横断面研究验证清单、纽卡斯尔-渥太华量表和 Cochrane 协作随机研究工具评估文章的方法学质量。基于营养不良或营养缺乏的患病率数据进行荟萃分析。该研究在 PROSPERO 中以 CRD 编号 42020175068 进行注册。
纳入了 1986 年至 2019 年间发表的 67 篇文章（N=453804）。大多数文章存在低偏倚风险，且没有因质量原因而排除发表。用于诊断营养状况的最广泛使用的人体测量指数是体重与年龄比，营养不良的估计患病率为 40%（95%CI=28.0-53.0）。有 9 篇文章调查了营养素缺乏情况，报道最多的是低钙血症和血清锌、铜和维生素 D 浓度降低。
我们在本综述中发现该人群中存在较高的营养不良率，此外，我们建议一些营养缺乏与食物缺乏有关，这些儿童的社会经济和年龄因素可能与较差的营养结局有关。这使得根据 CP 儿童的特点和特殊性进行监测和个性化营养管理变得必要。
