Background:

The aim of this review is to determine the relationship between gestational age (GA) and prevalence, type, distribution, and severity of cerebral palsy (CP). Epidemiological studies with cohorts expressed by GA were assessed. A comprehensive meta-analysis and metaregression was performed on four fetal age categories. Studies of children with CP as a target population were added. Twenty-six articles met the inclusion criteria. The prevalence of CP decreases significantly with increasing GA category: 14.6% at 22 to 27 weeks' gestation, 6.2% at 28 to 31 weeks, 0.7% at 32 to 36 weeks, and 0.1% in term infants. Interestingly, a significant decrease in prevalence of CP starts only from a GA of 27 weeks onwards. In preterm infants, spastic CP is predominant. In term infants, the non-spastic form of CP is more prevalent than in preterm infants. Bilateral spastic CP is most prevalent in both preterm and term infants. However, the proportion of unilateral spastic CP in term infants is substantial. No relationship could be detected between severity of CP and GA. There is a strong need for an international, well-described, and generally accepted classification system for subtypes and severity of CP.Cerebral palsy (CP) is one of the most common and well-recognized neurodevelopmental conditions, beginning in early childhood and persisting through the lifespan. 1 It is generally accepted that the risk of CP decreases with increasing gestational age (GA) of live-born infants. 2 Registers of childhood impairments and large population-based studies in Europe, [3][4][5][6][7][8] Japan, 9 and North America 10 monitored trends in rates of CP according to GA but focused mainly on the diagnosis of CP as a parameter reflecting the quality of perinatal care. Other studies were very fractionized and focused mostly on extremely and very preterm infants 11-22 but failed to present an overview of all age categories. In contrast, in these latter studies regarding extremely preterm infants, the presented prevalence rates of CP for each week of gestation are rather inconsistent and do not subscribe to the assumption that increasing GA results in decreasing rates of CP.In this meta-analysis we reveal the characteristics of the association between GA and CP. While exploring prevalence rates of CP in relation to GA, we found in several articles a link between GA and type and distribution of CP. Therefore, we looked for a relationship between GA and the characteristics of CP; specifically the type, distribution, and severity of CP. Method SEARCH STRATEGY AND STUDY SELECTIONTo explore the association between GA and the prevalence of

EDS-HT is characterised by various severe musculoskeletal complaints and has a detrimental effect on the habitual level of PA and HRQoL, in both physical and psychosocial dimension. An appropriate treatment and management in healthcare is needed.