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Risk of cerebral palsy and childhood epilepsy related to infections before or during pregnancy.

ABSTRACT: BACKGROUND AND AIM: Maternal infections during pregnancy have been associated with several neurological disorders in the offspring. However, given the lack of specificity for both the exposures and the outcomes, other factors related to infection such as impaired maternal immune function may be involved in the causal pathway. If impaired maternal immune function plays a role, we would expect infection before pregnancy to be associated with these neurological outcomes. METHODS/PRINCIPAL FINDINGS: The study population included all first-born singletons in Denmark between January 1 1982 and December 31 2004. We identified women who had hospital-recorded infections within the 5 year period before pregnancy, and women who had hospital-recorded infections during pregnancy. We grouped infections into either infections of the genitourinary system, or any other infections. Cox models were used to estimate adjusted hazard ratios (aHRs) with 95% confidence interval (CI). Maternal infection of the genitourinary system during pregnancy was associated with an increased risk of cerebral palsy (aHR?=?1.63, 95% CI: 1.34-1.98) and epilepsy (aHR?=?1.27, 95% CI: 1.13-1.42) in the children, compared to children of women without infections during pregnancy. Among women without hospital-recorded infections during pregnancy, maternal infection before pregnancy was associated with an increased risk of epilepsy (aHR?=?1.35, 95% CI: 1.21-1.50 for infections of the genitourinary system, and HR?=?1.12, 95% CI: 1.03-1.22 for any other infections) and a slightly higher risk of cerebral palsy (aHR?=?1.20, 95% CI: 0.96-1.49 for infections of the genitourinary system, and HR?=?1.23, 95% CI: 1.06-1.43 for any other infections) in the children, compared to children of women without infections before (and during) pregnancy. CONCLUSIONS: These findings indicate that the maternal immune system, maternal infections, or factors related to maternal immune function play a role in the observed associations between maternal infections before pregnancy and cerebral diseases in the offspring.

SUBMITTER: Wu CS

PROVIDER: S-EPMC3583873 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Risk of cerebral palsy and childhood epilepsy related to infections before or during pregnancy.

Wu Chun S CS Pedersen Lars H LH Miller Jessica E JE Sun Yuelian Y Streja Elani E Uldall Peter P Olsen Jørn J

PloS one 20130227 2

<h4>Background and aim</h4>Maternal infections during pregnancy have been associated with several neurological disorders in the offspring. However, given the lack of specificity for both the exposures and the outcomes, other factors related to infection such as impaired maternal immune function may be involved in the causal pathway. If impaired maternal immune function plays a role, we would expect infection before pregnancy to be associated with these neurological outcomes.<h4>Methods/principal ...[more]

PMID: 23460873

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Project description:BACKGROUND:Cerebral palsy (CP) is the most common physical developmental disability in childhood with a prevalence of 2 to 3 per 1000 live births. ?2-adrenoreceptor agonist (?2AA) are widely used for the treatment of asthma. Maternal use of ?2AAs may increase the risk of adverse neuro-psychiatric health outcomes in the offspring. No study, however, has evaluated the effect of prenatal exposure to ?2AAs on the risk of CP. OBJECTIVE:To examine the association between prenatal exposure to ?2AAs and the risk of childhood cerebral palsy. METHODS:This population-based cohort study included all live singleton births in Denmark from January 1, 1997 to December 31, 2003. The information on outpatient prescriptions of ?2AAs was extracted from Danish National Prescription Registry. Children born to mothers who used ?2AAs from 30 days before pregnancy until delivery were categorized as the exposed. To differentiate the effect of ?2AAs from the underlying indications, the exposure window was further extended to 2 years before pregnancy and the exposed groups were re-defined to represent different periods of exposure to maternal use of ?2AAs (use only before pregnancy, use only during pregnancy, and use both before and during pregnancy). Cases of CP were identified from the Danish Cerebral Palsy Register. Logistic regression was used to estimate incidence odds ratio (OR) of CP. RESULTS:Among all the 442,278 singletons, 19,616 (4.44%) were exposed to ?2AAs in utero (from 30 days before pregnancy until delivery). The risk of childhood CP was 0.21% in exposed and 0.19% in unexposed group, yielding an adjusted OR (aOR) 1.12 (95% confidence interval (CI): 0.82, 1.53). When extending the exposure time window to 2 years prior to pregnancy, no overall significant association was observed regardless of the exposure period. However, an increased risk of CP (aOR = 1.41, 95%CI: 0.92, 2.18) for maternal ?2AAs use during pregnancy was observed in female offspring, especially in those born at term (aOR = 1.65, 95%CI: 1.02, 2.67). This increase was mainly attributed to an increased risk in those born to mothers who used ?2AAs both before and during pregnancy (aOR = 1.81, 95%CI: 0.99, 3.33). CONCLUSIONS:We observed an association between maternal ?2AAs use during pregnancy and an increased risk of CP in female offspring, but we could not rule out confounding by the underlying indications for ?2AAs.

Dataset Information

Risk of cerebral palsy and childhood epilepsy related to infections before or during pregnancy.

Publications

Risk of cerebral palsy and childhood epilepsy related to infections before or during pregnancy.

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