Abstract

This letter discusses critical methodological limitations in the recent study by Elseed et al. on cerebral palsy (CP). While addressing an important public health issue, the study's conclusions are weakened by the absence of a control group from the same catchment area, making it impossible to establish true risk factors. Furthermore, a severe selection bias is present due to the tertiary center setting. The exceptionally high consanguinity rate (76.7%) heavily confounds the results, as genetic etiologies were not ruled out. Finally, major statistical inconsistencies regarding patient age and clinical classifications, along with significant recall bias for children up to 16 years, further reduce data reliability. Methodological refinements are suggested for future studies.