title: Cerebral palsy and perinatal infection in children born at term.
abstract: OBJECTIVE
  To investigate the link between infection-related risk factors for cerebral palsy subtypes in children born at term.
  
  
  METHODS
  A case-control study was performed in a population-based series of children with cerebral palsy born at term (n=309) matched with a control group (n=618). The cases were divided into cerebral palsy subtypes: spastic hemiplegia, spastic diplegia, spastic tetraplegia, and dyskinetic cerebral palsy. All forms of spastic cerebral palsy were also analyzed together. All records were examined for maternal and neonatal signs of infection. Univariate and adjusted analyses were performed.
  
  
  RESULTS
  Infection-related risk factors were shown to be independent risk factors for spastic cerebral palsy in the adjusted analyses. This was especially pronounced in the subgroup with spastic hemiplegia in which bacterial growth in urine during pregnancy (n=11 [7.5%], odds ratio [OR] 4.7, 95% confidence interval [CI] 1.5-15.2), any infectious disease during pregnancy (n=57 [39.0%], OR 2.9, 95% CI 1.7-4.8), severe infection during pregnancy (n=12 [8.2%], OR 15.4, 95% CI 3.0-78.1), antibiotic therapy once during pregnancy (n=33 [22.6%], OR 6.3, 95% CI 3.0-15.2) as well as several times during pregnancy (n=9 [6.2%], OR 15.6, 95% CI 1.8-134.2) constituted strong independent risk factors. However, only neonatal infection (n=11 [9.1%], OR 14.7, 95% CI 1.7-126.5) was independently significantly associated with an increased risk of spastic diplegia and tetraplegia.
  
  
  CONCLUSIONS
  Infection-related factors are strong independent risk factors for the subgroup with spastic hemiplegia in children with cerebral palsy born at term. The finding is less pronounced in the subgroups with spastic diplegia or tetraplegia.
  
  
  METHODS
  II.
authors.affiliation: Perinatal Center, Department of Obstetrics and Gynaecology, Institute for Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra, and the Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; the Department of Obstetrics and Gynaecology, Charles University in Prague, Medical Faculty Hradec Kralove, Prague, Czech Republic; the Maternal Fetal Medicine Department, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; and the Department of Genes and Environment, Division of Epidemiology, Institute of Public Health, Oslo, Norway.
authors.forename: Kristina
authors.initials: K
authors.lastname: Ahlin
authors.forename: Kate
authors.initials: K
authors.lastname: Himmelmann
authors.forename: Gudrun
authors.initials: G
authors.lastname: Hagberg
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovsky
authors.forename: Teresa
authors.initials: T
authors.lastname: Cobo
authors.forename: Ulla-Britt
authors.initials: UB
authors.lastname: Wennerholm
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
mesh_terms: D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007231:Infant, Newborn; D007239:Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology