Chen Dandan, Huang Meiyuan, Yin Yangyan, Gui Dongmei, Gu Yuniao, Zhuang Taiping, Chen Caihua, Huo Kaiming
Department of Pediatrics, the First Affiliated Hospital of Hainan Medical University, Haikou, China.
Department of Neonatology, Hainan Women and Children's Medical Center, Haikou, China.
Transl Pediatr. 2022 Apr;11(4):556-564. doi: 10.21037/tp-22-78.
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.
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.
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.
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.
本研究旨在通过对脑瘫危险因素文献的荟萃分析，探讨儿童脑瘫的主要危险因素。
我们使用以下检索词对PubMed、EMBASE、Medline和CENTRAL数据库进行文献检索：（“cerebrl plsy”或“cerebrl plsis”或“婴儿脑瘫”）以及（“危险因素”）。纳入脑瘫患儿和健康儿童的病例对照或队列研究进行荟萃分析。采用病例对照研究的纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。使用卡方检验来检验文献的异质性。本研究采用亚组分析和敏感性分析来识别异质性来源。如果亚组分析和敏感性分析无法识别异质性来源，则不进行研究结果的合并，仅描述个别研究结果。在本研究中，使用Egger检验来检验发表偏倚。存在异质性时使用随机效应模型，不存在异质性时应用固定效应模型。
共检索到1836篇相关文章。筛选后，13篇文章纳入分析，共涉及2489例脑瘫患儿和4782例非脑瘫患儿。纳入的文章均未达到NOS评分为9分，4篇文章评分为8分，8篇文章评分为7分，1篇文章评分为6分。荟萃分析表明，孕期母亲高血压、胎膜早破、早产和急诊剖宫产是儿童脑瘫的危险因素，文献间不存在异质性且无发表偏倚。
本研究通过荟萃分析确定妊娠期高血压、早产、胎膜早破和急诊剖宫产为儿童脑瘫的危险因素，为风险监测和临床干预提供参考。
