Maternal diagnosis of obesity and risk of cerebral palsy in the child.
OBJECTIVE
To examine the association between maternal hospital diagnoses of obesity and risk of cerebral palsy (CP) in the child.


METHODS
For all California hospital births from 1991-2001, we linked infant and maternal hospitalization discharge abstracts to California Department of Developmental Services records of children receiving services for CP. We identified maternal hospital discharge diagnoses of obesity (International Classification of Diseases, 9th edition 646.1, 278.00, or 278.01) and morbid obesity (International Classification of Diseases, 9th edition 278.01), and performed logistic regression to explore the relationship between maternal obesity diagnoses and CP.


RESULTS
Among 6.2 million births, 67 200 (1.1%) mothers were diagnosed with obesity, and 7878 (0.1%) with morbid obesity; 8798 (0.14%) children had CP. A maternal diagnosis of obesity (relative risk [RR] 1.30, 95% CI 1.09-1.55) or morbid obesity (RR 2.70, 95% CI 1.89-3.86) was associated with increased risk of CP. In multivariable analysis adjusting for maternal race, age, education, prenatal care, insurance status, and infant sex, both obesity (OR 1.27, 95% CI 1.06-1.52) and morbid obesity (OR 2.56, 95% CI 1.79-3.66) remained independently associated with CP. On stratified analyses, the association of obesity (RR 1.72, 95% CI 1.25-2.35) or morbid obesity (RR 3.79, 95% CI 2.35-6.10) with CP was only significant among women who were hospitalized prior to the birth admission. Adjusting for potential comorbidities and complications of obesity did not eliminate this association.


CONCLUSIONS
Maternal obesity may confer an increased risk of CP in some cases. Further studies are needed to confirm this finding.
Department of Neurology, University of California, San Francisco, San Francisco, CA.
Mary D
MD
Crisham Janik
Thomas B
TB
Newman
Yvonne W
YW
Cheng
Guibo
G
Xing
William M
WM
Gilbert
Yvonne W
YW
Wu
D000328:Adult; D002140:California; D002547:Cerebral Palsy / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications*; D009767:Obesity, Morbid / Q000150:complications; D011247:Pregnancy; D011248:Pregnancy Complications; D015995:Prevalence; D012042:Registries; D012307:Risk Factors
C-reactive protein; CP; CRP; Cerebral palsy; DDS; Department of Developmental Services; ICD-9; IL; Interleukin; International Classification of Diseases 9th edition; OSHPD; Office of Statewide Health Planning and Development; RR; Relative risk