Does peripartum infection increase the incidence of cerebral palsy in extremely low birthweight infants?
OBJECTIVE
This study was undertaken to determine the perinatal predictors of cerebral palsy in extremely low birthweight infants (<1000 g).


METHODS
A case control study of infants with birthweight of less than 1000 g (19 with cerebral palsy and 38 controls) who survived beyond 18-22 months of corrected age was performed. Outcome variables included maternal demographics, obstetric complications, and neonatal outcome (gestational age at delivery, birthweight, Apgar scores, intrauterine growth restriction, respiratory distress syndrome, intraventricular hemorrhage, and neonatal sepsis). Data analysis consisted of t tests, chi2, and analysis of variance when appropriate.


RESULTS
There were no significant differences between cerebral palsy and control groups with regard to mode of delivery, Apgar scores, preeclampsia, antenatal vaginal bleeding, or the use of magnesium sulfate. However, male gender (odds ratio 3.70; 95% CI 1.05-12.5), primigravid status (odds ratio 5.52; 95% CI 1.67-18.3), early neonatal sepsis (odds ratio 12.9; 95% CI 2.94-57.2) and chorioamnionitis, both clinical and histologic (odds ratio 3.71; 95% CI 1.16-11.9) were significantly associated with the development of cerebral palsy. The strong association between cerebral palsy and chorioamnionitis, as well as early neonatal sepsis, remain significant after adjustment for primigravid status and male gender.


CONCLUSIONS
In extremely low birthweight infants, cerebral palsy was strongly associated with chorioamnionitis, early neonatal sepsis, male gender, and primigravid status.
Costantine
Maged M
MM
University of Cincinnati, Cincinnati, OH, USA.
How
Helen Y
HY
Coppage
Kristin
K
Maxwell
Rose A
RA
Sibai
Baha M
BM
D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000453:epidemiology* / Q000209:etiology; D002821:Chorioamnionitis / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D018805:Sepsis / Q000150:complications*