title: Maternal hypertension and intrapartum fever are associated with increased risk of ischemic stroke during infancy.
abstract: OBJECTIVE
  To examine maternal hypertension, diabetes, and intrapartum fever as potential risk factors for ischemic stroke in infants.
  
  
  METHODS
  We conducted a retrospective cohort study of 226,117 children born from January 2000 to December 2007 who were enrolled in the South Carolina Medicaid program. We linked maternal and child Medicaid billing records and birth certificate data. Children with ischemic stroke were identified based on the International Classification of Diseases, Ninth Revision (ICD-9), code 434 in the child's billing data. Independent variables and covariates were identified using ICD-9 codes and birth certificate data. We modeled the odds of ischemic stroke diagnosis in infants, either before 30 days of life or before 365 days.
  
  
  RESULTS
  Forty-three children were diagnosed with ischemic stroke before 30 days and 161 before 365 days. Maternal hypertension (odds ratio 2.31 before 30 d) and intrapartum fever (odds ratio 3.36 <30 d) were significantly associated with odds of ischemic stroke before 30 days and before 365 days; maternal diabetes was not.
  
  
  CONCLUSIONS
  Maternal hypertension and intrapartum fever appear to be risk factors for ischemic stroke in infants. Additional research is needed to determine the mechanism(s) underlying these associations and to develop effective preventive methods for high-risk infants.
authors.affiliation: Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC 29203, USA. joshua.mann@sc.edu
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Mann
authors.forename: Suzanne
authors.initials: S
authors.lastname: McDermott
authors.forename: Chun
authors.initials: C
authors.lastname: Pan
authors.forename: James W
authors.initials: JW
authors.lastname: Hardin
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D007223:Infant; D016015:Logistic Models; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D014481:United States; D055815:Young Adult