 |
|
Intrauterine Exposure to Infection and Risk of Cerebral Palsy in Very Preterm Infants
Judith K. Grether, PhD;
Karin B. Nelson, MD;
Eileen Walsh, RN;
Rodney E. Willoughby, MD;
Raymond W. Redline, MD
Arch Pediatr Adolesc Med. 2003;157:26-32.
Objective To evaluate exposure to intrauterine infection as an independent risk factor for spastic cerebral palsy (CP) among very prematurely born infants.
Study Design Retrospective case-control study.
Methods Singleton children with gestational ages less than 32 weeks and birth weights less than 1999 g who survived to age 2 years and were born from 1988 to 1994 in a level 2 or 3 hospital in California were included in the study. Cases were children with congenital spastic CP (n = 170). Controls were children randomly sampled within 250-g birth weight intervals (n = 270). Gestational age was controlled through multiple logistic models. Major analyses were controlled for preeclampsia and short time between admission and delivery.
Results Neither clinical nor histologic indicators of intrauterine infection were associated with total spastic CP or spastic diplegia in these infants. Although not predicted by prior hypothesis, we observed an approximate doubling of risk for infants of infected mothers among children born to white women, whereas no association was noted among children born to women of other races/ethnicities. White controls had lower frequency of all measured infection indicators compared with white cases and cases and controls of other races/ethnicities.
Conclusion Exposure to intrauterine infection was not an independent risk factor for CP in very premature infants when gestational age and other confounders were tightly controlled.
From the California Birth Defects Monitoring Program (Dr Grether and Ms Walsh) and the Environmental Health Investigations Branch (Dr Grether), California Department of Health Services, Oakland; the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md (Dr Nelson); Alta Bates/Summit Medical Center, Berkeley, Calif (Ms Walsh); the Division of Infectious Diseases, Department of Pediatrics, John Hopkins University, Baltimore, Md (Dr Willoughby); and the Department of Pathology, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio (Dr Redline).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Cerebral White Matter Injury: The Changing Spectrum in Survivors of Preterm Birth
Back and Miller
NeoReviews 2007;8:e418-e424.
ABSTRACT
| FULL TEXT
Topical Review: Role of Instrumented Fetal Sheep Preparations in Defining the Pathogenesis of Human Periventricular White-Matter Injury
Back et al.
J Child Neurol 2006;21:582-589.
ABSTRACT
Cerebral Palsy and the Application of the International Criteria for Acute Intrapartum Hypoxia.
Strijbis et al.
Obstet Gynecol 2006;107:1357-1365.
ABSTRACT
| FULL TEXT
Chorioamnionitis and Cerebral Palsy in Term and Near-Term Infants
Wu et al.
JAMA 2003;290:2677-2684.
ABSTRACT
| FULL TEXT
Can We Prevent Cerebral Palsy?
Nelson
NEJM 2003;349:1765-1769.
FULL TEXT
Beware Observational Studies in Neonatal Practice
Willoughby
Arch Pediatr Adolesc Med 2003;157:934-935.
FULL TEXT
Intrauterine Infection Not an Independent Risk Factor for CP in Very Preterm Infants
Lindsay
AAP Grand Rounds 2003;9:46-47.
FULL TEXT
|
