Maternal Infections during Pregnancy and Cerebral Palsy: A Population‐based Cohort Study. Issue 6 (10th October 2013)

• Record Type: Journal Article
• Authors: Miller, Jessica E.; Pedersen, Lars Henning; Streja, Elani; Bech, Bodil H.; Yeargin‐Allsopp, Marshalyn; Van Naarden Braun, Kim; Schendel, Diana E.; Christensen, Deborah; Uldall, Peter; Olsen, Jørn
• Is Part Of: Paediatric and perinatal epidemiology. Volume 27:Issue 6(2013)
• Page Start: 542
• Page End: 552
• Publication Date: 2013-10-10
• Subjects: Pediatrics -- Periodicals; Perinatology -- Periodicals; Pediatric epidemiology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; 618.92
• DOI: 10.1111/ppe.12082
• Languages: English
• ISSNs: 0269-5022

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ppe12082-sec-0001" sec-type="section"> <title>Background</title> <p>Cerebral palsy (CP) is a common motor disability in childhood. We examined the association between maternal infections during pregnancy and the risk of congenital CP in the child.</p> </sec> <sec id="ppe12082-sec-0002" sec-type="section"> <title>Methods</title> <p>Liveborn singletons in Denmark between 1997 and 2003 were identified from the Danish National Birth Registry and followed from 1 year of life until 2008. Redemption of antibiotics from the National Register of Medicinal Product Statistics and maternal infections reported by the National Hospital Register were used as markers of maternal infection during pregnancy. CP diagnoses were obtained from the Danish Cerebral Palsy Registry. Adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated by Cox proportional hazard models.</p> </sec> <sec id="ppe12082-sec-0003" sec-type="section"> <title>Results</title> <p>Of the 440 564 singletons with follow‐up data, 840 were diagnosed with congenital CP. Maternal genito‐urinary tract infections (HR 2.1, 95% CI 1.4, 3.2) were associated with CP in all births, in term births (HR 1.9, 95% CI 1.1, 3.2), in children with spastic CP (HR 2.1, 95% CI 1.4, 3.3), and among first‐born children (HR 1.9, 95% CI 1.4, 3.3). Overall, we found associations between redeemed nitrofurantoin (HR 1.7, 95% CI 1.1, 2.8) and CP. Among trimester‐specific exposures, CP risk was associated with prescriptions redeemed in the first trimester for any antibacterials, beta‐lactam antibacterials, and nitrofurantoin, an antibiotic commonly used to treat lower urinary tract infection, and genito‐urinary tract infections in the third trimester.</p> </sec> <sec id="ppe12082-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Genito‐urinary tract infections and antibiotic use during pregnancy were associated with increased risks of CP, indicating that some maternal infections or causes of maternal infections present in prenatal life may be part of a causal pathway leading to CP.</p> </sec> </abstract>