Maternal genitourinary infection and risk of cerebral palsy

Abstract

Aim: To examine the association between genitourinary infection during pregnancy and cerebral palsy (CP) in children.

Method: Medicaid and birth certificate data were obtained for 135 835 pregnant women with singleton births paid for by Medicaid from 1996 to 2002. Linked Medicaid billing data were obtained for their children in 2007. The association between maternal genitourinary infection and CP was modeled using generalized estimating equations.

Results: Maternal genitourinary infection was significantly associated with CP (odds ratio [OR]=1.27, p=0.007). Additional analyses revealed that the association was strongly significant for preterm or low birthweight infants when maternal infection was diagnosed in the first two trimesters of pregnancy (OR=1.62, p<0.001). This association remained (OR=1.72, p<0.001) when the model was limited to cases of CP diagnosed by at least two different clinicians. Infection was not significantly associated with CP in term or normal-birthweight infants.

Interpretation: Maternal genitourinary infection occurring in the first two trimesters was associated with increased risk of CP in preterm or low-birthweight children. Additional research is needed to determine whether this association is affected by antimicrobial treatment.