Increasing prevalence of cerebral palsy among children and adolescents in China 1988-2020: A systematic review and meta-analysis.

Abstract

To investigate the pooled prevalence of cerebral palsy in China, analyse the differences between different subgroups, and explore the trend over the 32-year period from 1988 to 2020. All potential studies related to the prevalence of cerebral palsy among children and adoles-cents in China were identified from 3 English- language databases and 4 Chinese-language databases. Pooled prevalence was calculated to estimate the prevalence of cerebral palsy among 0-18 years old and different geographical regions in China, using a random-effects meta-analysis model. Continuous fractional polynomial regression modelling was used to estimate the trend in prevalence of cerebral palsy over time. Subgroup analysis and meta-regression were conducted to investigate heterogeneity. Funnel plots and Egger s test were used to explore potential publication bias. The pooled prevalence of cerebral palsy over the study period among 0-18 years old and different geographical regions in China was 2.07% (95% confidence interval (95% CI) 1.66-2.47%), and the prevalence of cerebral palsy was higher in males compared with females (2.25% vs 1.59%), and in rural residents compared with urban residents (2.54% vs 1.9%), respectively. The prevalence of cerebral palsy varied significantly between different geographical regions. In subjects with birthweights <\u20092.5 and >\u20094 kg the prevalence of cerebral palsy was significantly higher than in subjects with birthweights between 2.5 and 4 kg. The trend in pooled prevalence of cerebral palsy increased continuously over the period studied, and could be divided into 3 stages; the mean annual increase in prevalence from 1988 to 1996 and from 2008 to 2019 was more rapid. Multivariate meta-regression found that the year of study was one of the sources of heterogeneity among overall prevalence. (p=0.006). The pooled prevalence of cerebral palsy over the 32-year period from 1988 to 2020 was 2.07%. There was an increasing trend in prevalence of cerebral palsy among children and adolescents in China over this period.