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Advanced Neurology Neonatal encephalopathy and cerebral palsy

Table 1. Characteristics of CP patients included in the
present analysis
Characteristic Number of cases
Total patients 1657
With NE 413
With HIE 91
Without NE/HIE 1153
Total patients with gender 263
specified in the included studies
Male 146
Female 117
Abbreviations: CP: Cerebral palsy; HIE: Hypoxic-ischemic
encephalopathy; NE: Neonatal encephalopathy.
total CP patients, with an OR of 0.18 (95% CI: 0.10 – 0.32,
P < 0.00001).
To investigate potential sex-specific differences in the
incidence of CP patients with an NE history, a separate
analysis of NE incidence in male and female CP patients
was conducted using data from two studies categorizing
Figure 2. Flow diagram of publication selection. A total of 424 studies CP cases by biological sex (Figure 4). The total number of
were collected from the two electronic databases, with 355 identified as cases with or without preceding NE conditions was pooled
duplicates either within or across databases. After removing duplicates, together across the two studies, and the number of cases
69 studies were selected. Out of these, 58 were excluded – 57 due to a for each sex was counted within each group. In both patient
lack of reported cases of cerebral palsy with preceding hypoxic-ischemic groups, male CP patients exhibited a marginally increased
encephalopathy or NE and 1 due to inaccessibility. Subsequently, a full-
text review was conducted on 11 studies. After the full-text review, an incidence compared to female CP patients (with NE
additional 5 articles were excluded because they lacked a comparison conditions: OR: 0.4, 95% CI: 0.06 – 2.54, P = 0.33; without
between CP patients with or without NE conditions. Ultimately, the NE conditions: OR: 0.73, 95% CI: 0.48 – 1.09, P = 0.12).
present analysis is based on 7 studies. However, this difference was not statistically significant at
Abbreviations: CP: Cerebral palsy; NE: Neonatal encephalopathy.
the p<0.05 level. Further clinical studies comparing male
and female cases are warranted to determine whether the
all were used to analyze the incidence of NE in CP patients, 3 incidence of NE in CP patients is significantly affected by
were used to analyze the subtype and comorbidities of CP with biological sex.
and without preceding NE studies [33,41,42] , and 2 studies were
used to assess NE incidence in CP patients across sex [33,42] . 3.4. Severity of cerebral palsy complications in
3.2. Study participants patients with and without preceding NE
To determine if CP subtypes exhibit variations with and
In total, data from 1657 CP patients were available (Table 1)
for analyzing the incidence of CP with or without preceding without preceding NE, individuals with CP were divided
NE conditions. Among these, 504 CP cases were associated into 2 major categories of CP subtypes: (i) the most severe
with preceding NE, while 1153 were not. The sex of patients spastic quadriplegic subtype and (ii) spastic diplegia,
hemiplegia, dyskinesia, and other subtypes. Analysis was
was specified in 263 cases, comprising 146 male and
117 female patients. It is noteworthy that all cases included performed to identify the incidence of these subtypes in
in the subtype and comorbidities analyses were neonates those who experienced preceding NE conditions and
born at term and were followed up for a duration of 5 years. those who did not (Figure 5). The incidence of spastic
quadriplegic subtype was found to be significantly higher
3.3. Incidence of NE in cerebral palsy patients in those with CP that had experienced NE compared to
CP patients that did not have prior reports of NE with
To assess the incidence of preceding NE in CP patients, OR: 4.34 (95% CI: 2.69 – 7.00, P < 0.00001).
the numbers of CP cases with or without an NE history
were collected and analyzed (Figure 3). A small cohort To further explore whether CP patients with preceding
of patients with an NE history was identified among the NE conditions manifest different symptoms associated

Volume 2 Issue 4 (2023) 4 https://doi.org/10.36922/an.1719