Aim: To determine trends and current estimates in regional and global prevalence of cerebral palsy (CP).Method: A systematic analysis of data from participating CP registers/surveillance systems and population‐based prevalence studies (from birth year 1995) was performed. Quality and risk of bias were assessed for both data sources. Analyses were conducted for pre‐/perinatal, postnatal, neonatal, and overall CP. For each region, trends were statistically classified as increasing, decreasing, heterogeneous, or no change, and most recent prevalence estimates with 95% confidence intervals (CI) were calculated. Meta‐analyses were conducted to determine current birth prevalence estimates (from birth year 2010).Results: Forty‐one regions from 27 countries across five continents were represented. Pre‐/perinatal birth prevalence declined significantly across Europe and Australia (11 out of 14 regions), with no change in postneonatal CP. From the limited but increasing data available from regions in low‐ and middle‐income countries (LMICs), birth prevalence for pre‐/perinatal CP was as high as 3.4 per 1000 (95% CI 3.0–3.9) live births. Following meta‐analyses, birth prevalence for pre‐/perinatal CP in regions from high‐income countries (HICs) was 1.5 per 1000 (95% CI 1.4–1.6) live births, and 1.6 per 1000 (95% CI 1.5–1.7) live births when postneonatal CP was included.Interpretation: The birth prevalence estimate of CP in HICs declined to 1.6 per 1000 live births. Data available from LMICs indicated markedly higher birth prevalence.What this paper adds: • Birth prevalence of pre‐/perinatal cerebral palsy (CP) in high‐income countries (HICs) is decreasing.• Current overall CP birth prevalence for HICs is 1.6 per 1000 live births.• Trends in low‐ and middle‐income countries (LMICs) cannot currently be measured.• Current birth prevalence in LMICs is markedly higher than in HICs.• Active surveillance of CP helps to assess the impact of medical advancements and social/economic development.• Population‐based data on prevalence and trends of CP are critical to inform policy.

Aim: Determining inclusion/exclusion criteria for cerebral palsy (CP) surveillance is challenging. The aims of this paper were to (1) define inclusion/exclusion criteria that have been adopted uniformly by surveillance programmes and identify where consensus is still elusive, and (2) provide an updated list of the consensus concerning CP inclusion/exclusion when a syndrome/disorder is diagnosed.Method: Data were drawn from an international survey of CP registers, the New South Wales CP Register (1993–2003), the Western Australian CP Register (1975–2008), and the Surveillance of CP in Europe (SCPE; 1976–1998). An expert panel used a consensus building technique, which utilized the SCPE ‘decision tree’ and the original ‘What constitutes cerebral palsy?’ paper as frameworks.Results: CP surveillance programmes agree on key clinical criteria pertaining to the type, severity, and origin of motor disorder in CP. Further work is warranted to reach agreement for (1) minimum age of survival and maximum age of postneonatal brain injury, and (2) metabolic disorders with highly variable clinical courses/responses to treatment. One hundred and ninety‐seven syndromes/disorders were reviewed and advice on their inclusion/exclusion is provided.Interpretation: What constitutes CP will continue to evolve as diagnostics improve. Surveillance programmes throughout the world are committed to addressing their differences regarding inclusion/exclusion criteria for the umbrella term CP.

The causes and pathogenesis of cerebral palsy (CP) are all poorly understood, particularly in low- and middle-income countries (LMIC). There are gaps in knowledge about CP in Bangladesh, especially in the spheres of epidemiological research, intervention and service utilization. In high-income countries CP registers have made substantial contributions to our understanding of CP. In this paper, we describe a pilot study protocol to develop, implement, and evaluate a CP population register in Bangladesh (i.e., Bangladesh Cerebral Palsy Register - BCPR) to facilitate studies on prevalence, severity, aetiology, associated impairments and risk factors for CP. The BCPR will utilise a modified version of the Australian Cerebral Palsy Register (ACPR) on a secured web-based platform hosted by the Cerebral Palsy Alliance Research Institute, Australia. A standard BCPR record form (i.e., data collection form) has been developed in consultation with local and international experts. Using this form, the BPCR will capture information about maternal health, birth history and the nature of disability in all children with CP aged <18 years. The pilot will be conducted in the Shahjadpur sub-district of Sirajgonj district in the northern part of Bangladesh. There are 296 villages in Shahjadpur, a total population of 561,076 (child population ~ 226,114), an estimated 70,998 households and 12,117 live births per annum. Children with CP will be identified by using the community based Key Informants Method (KIM). Data from the completed BPCR record together with details of assessment by a research physician will be entered into an online data repository. Once implemented, BCPR will be, to the best of our knowledge, the first formalised CP register from a LMIC. Establishment of the BCPR will enable estimates of prevalence; facilitate clinical surveillance and promote research to improve the care of individuals with CP in Bangladesh.