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Pediatr Neurol. 2018 Mar;80:77-83. doi: 10.1016/j.pediatrneurol.2017.11.006. Epub 2017 Dec 13.

Neonatal Infection in Children With Cerebral Palsy: A Registry-Based Cohort Study.

Author information

1
Department of Pediatrics, McGill University, Montreal, Quebec, Canada.
2
Department of Pediatrics, Division of Neonatology, University of Toronto, Toronto, Ontario, Canada.
3
Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
4
Department of Pediatrics, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada.
5
Janeway Health Centre, St. John's NL, Department of Paediatrics, Canada.
6
University of Toronto, Bloorview Research Institute, Toronto, Ontario, Canada.
7
Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada.
8
Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada.
9
Developmental Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada.
10
Department of Pediatrics, McGill University, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
11
Department of Pediatrics, McGill University, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada. Electronic address: maryam.oskoui@mcgill.ca.

Abstract

BACKGROUND:

The goal of this study was to explore the association between neonatal infection and outcomes in children with cerebral palsy.

METHODS:

We conducted a retrospective cohort study using the Canadian CP Registry. Neonatal infection was defined as meeting one of the following criteria: (1) septicemia, (2) septic shock, or (3) administration of antibiotics for ≥10 days. Phenotypic profiles of children with cerebral palsy with and without an antecedent neonatal infection were compared. Subgroup analysis was performed, stratified by gestational age (term versus preterm).

RESULTS:

Of the 1229 registry participants, 505 (41.1%) were preterm, and 192 (15.6%) met the criteria for neonatal infection with 29% of preterm children having a neonatal infection compared with 6.5% in term-born children. Children with prior neonatal infection were more likely to have a white matter injury (odds ratio 2.2, 95% confidence interval 1.5 to 3.2), spastic diplegic neurological subtype (odds ratio 1.6, 95% confidence interval 1.1 to 2.3), and sensorineural auditory impairment (odds ratio 2.1, 95% confidence interval 1.4 to 3.3). Among preterm children, neonatal infection was not associated with a difference in phenotypic profile. Term-born children with neonatal infection were more likely to have spastic triplegia or quadriplegia (odds ratio 2.4, 95% confidence interval 1.3 to 4.3), concomitant white matter and cortical injury (odds ratio 4.1, 95% confidence interval 1.6 to 10.3), and more severe gross motor ability (Gross Motor Function Classification System IV to V) (odds ratio 2.6, 95% confidence interval 1.4 to 4.8) compared with preterm children.

CONCLUSIONS:

Findings suggest a role of systemic infection on the developing brain in term-born infants, and the possibility to develop targeted therapeutic and preventive strategies to reduce cerebral palsy morbidity.

KEYWORDS:

cerebral palsy; neonatal infection; neurodevelopment; registry; retrospective cohort

[Indexed for MEDLINE]

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