Abstract Details

Title Non-ambulatory Status and Risk of Severe Vitamin D Deficiency in Children with Cerebral Palsy: A Systematic Review and Meta-analysis

Topic Child Neurology and Developmental Neurology

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 8-010

Objective The aim of this meta-analysis is to estimate the increased risk of Vitamin D Deficiency (VDD) associated with non-ambulatory status (Gross Motor Function Classification System [GMFCS] Levels IV-V) compared to ambulatory status (GMFCS Levels I-III) to estimate evidence-based screening protocols.

Background Vitamin D deficiency significantly compromises bone health and motor function in Cerebral Palsy (CP), yet a unified risk quantification for the most severely affected children has been lacking. Establishing this quantification is essential to guide standardized screening practices.

Design/Methods We conducted a random-effects meta-analysis of observational studies that reported serum 25(OH)D levels and GMFCS classification in children with cerebral palsy aged 0-18 years. Vitamin D deficiency was typically defined using 25(OH)D cutoffs below 20 ng/ml. Six studies (N=676 CP patients) were included, with four contributing 2×2 count data for the primary analysis. The Risk of bias was evaluated using Newcastle-Ottawa Scale (NOS).

Results The pooled analysis demonstrated a strong and consistent association between severe motor impairment and VDD risk. Non-ambulatory children (GMFCS IV-V) had 2.62 times greater odds of Vitamin D deficiency compared to those who were ambulatory (OR = 2.62; 95% CI : 1.38, 4.98). We observed considerable variability across the studies (I²= 59.8%). A Sensitivity analysis excluding one outlier study confirmed that the association remained significant (OR of 3.21; 95% CI : 1.87, 5.51) with lower heterogeneity (I² = 44.9%). The median Newcastle-Ottawa Scale score was 6 of 9, indicating moderate risk of bias.

Conclusions Non-ambulatory status (GMFCS IV-V) is a major risk factor for vitamin D deficiency in children with cerebral palsy. These findings highlight the need to include routine vitamin D screening and prophylactic supplementation in non-ambulatory pediatric CP care.

Authors/Disclosures
Meet Kachhadia, MBBS PRESENTER	Dr. Kachhadia has nothing to disclose.
Neel K. Parikh	Mr. Parikh has nothing to disclose.
Bharat Parmar (Zydus Medical College and Hospital, Dahod)	No disclosure on file
Aishwarya Koppanatham, MBBS	Ms. Koppanatham has nothing to disclose.
Anis Shaikh (Zydus Medical College and Hospital Dahod)	No disclosure on file
Neha Parmar (Zydus Medical College and Hospital India)	No disclosure on file