Maternal Infections During Pregnancy and Cerebral Palsy in the Child.
Maternal Infections During Pregnancy and Cerebral Palsy in the Child.
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DOI：
10.1016/j.pediatrneurol.2015.12.018
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发表时间：
2016-04
影响因子：
3.8
通讯作者：
Wu YW
中科院分区：
文献类型：
--
作者：
Bear JJ;Wu YW
小儿脑瘫的早期症状有哪些？羊膜外感染和脑瘫之间的关系研究较少。我们检查了母亲的羊膜内和羊膜外感染和孩子脑瘫的风险。在1991-2001年600万名加州出生的回顾性队列中，我们分析了与加州发育服务部接受脑瘫服务的所有儿童记录相关的行政孕产妇和新生儿出院摘要。我们确定了分娩前12个月内发生的羊膜内（绒毛膜炎）和羊膜外（其他泌尿生殖道和呼吸道）感染的孕产妇医院诊断。采用多变量逻辑回归分析，我们确定了产妇感染和脑瘫之间的独立关联，调整了婴儿性别，产妇年龄，种族，教育，社会经济地位和肥胖。5.5%的母亲出院时至少有以下一种诊断：绒毛膜炎（2.0%）、其他泌尿生殖系统感染（3.1%）和呼吸道感染（0.6%）。8，473名脑瘫婴儿的母亲比未患病儿童的母亲更常见感染诊断（13.7% vs. 5.5%，P<0.001）。在多变量分析中，所有三种类型的母体感染（绒毛膜炎，OR 3.1，95% CI 2.9-3.4;其他泌尿生殖系统感染，OR 1.4，95% CI 1.3-1.6;呼吸道感染，OR 1.9，95% CI 1.5-2.2）均与脑瘫相关。母体羊膜外感染，无论是在产前诊断或出生住院，赋予脑瘫的风险增加。母亲在怀孕期间在医院诊断的羊膜外感染与孩子脑瘫的风险适度增加有关。
Chorioamnionitis is a risk factor for cerebral palsy. The relationship between extra-amniotic infections and cerebral palsy is less well studied. We examined maternal intra- and extra-amniotic infections and risk of cerebral palsy in the child. Among a retrospective cohort of six million Californian births, 1991–2001, we analyzed administrative maternal and newborn hospital discharge abstracts linked to records of all children receiving services for cerebral palsy at the California Department of Developmental Services. We identified maternal hospital diagnoses of intra-amniotic (chorioamnionitis) and extra-amniotic (other genitourinary and respiratory) infections occurring up to twelve months before delivery. Using multivariable logistic regression, we determined the independent association between maternal infections and cerebral palsy, adjusting for infant sex, maternal age, race, education, socioeconomic status, and obesity. 5.5% of mothers had a hospital discharge diagnosis of at least one of the following: chorioamnionitis (2.0%), other genitourinary (3.1%), and respiratory infection (0.6%). An infection diagnosis was more common in mothers of the 8,473 infants with cerebral palsy than in mothers of unaffected children (13.7% vs. 5.5%, P<0.001). All three types of maternal infections (chorioamnionitis, OR 3.1, 95% CI 2.9–3.4; other genitourinary infection, OR 1.4, 95% CI 1.3–1.6; and respiratory infection, OR 1.9, 95% CI 1.5–2.2) were associated with cerebral palsy in multivariable analyses. Maternal extra-amniotic infections, whether diagnosed during prenatal or birth hospitalizations, conferred an increased risk of cerebral palsy. Maternal extra-amniotic infections diagnosed in the hospital during pregnancy are associated with a modestly increased risk of cerebral palsy in the child.