Pre-eclampsia poses cerebral palsy risk for premature and small babies

Exposure to pre-eclampsia is associated with an increased risk of cerebral palsy in newborns, if they are preterm or small at birth, suggests a study published today in BMJ.

Pre-eclampsia affects 3-5% of and can lead to preterm delivery, prematurity, perinatal morbidity and mortality. Although preterm birth and low birth weight are associated with excess risk of CP, the causes remain largely unknown.

Some studies have found an excess risk of CP in children born at term from mothers with pre-eclampsia while others have reported no association.

Researchers from Norway therefore tested the hypothesis that pre-eclampsia poses a risk of CP in preterm and . This is the first study to report that the association between pre-eclampsia exposure and CP may be mediated by being small at birth.

Data were used from the CP Registry of Norway (CPRN) and the Medical Birth Registry of Norway (MBRN). Data were taken on all in Norway between 1996 and 2006. The researchers consider the study group to be representative of the total CP population born in Norway in this time period.

The final study population included 849 children with CP and 616,658 children without. All children with CP had their diagnosis confirmed when they were at least four years old and cases were diagnosed and classified according to the Surveillance and CP in Europe guidelines.

Duration of pregnancy was divided into: term birth (more than 36 weeks), moderate preterm birth (32-36 weeks) and very preterm birth (less than 31 weeks). Rates were adjusted for mother's age at delivery, infant sex, birth weight and if the child was born through IVF (in vitro ).

Children who were both born moderately preterm (between 32 and 36 weeks) and very preterm (less than 31 weeks) and exposed to pre-eclampsia had a significantly increased risk of CP, if they were also smaller than usual at birth. Results did not change by adjusting for , parity, smoking in pregnancy, IVF or sex of the child.

Among children born at term, exposed children born at normal weight did not have excess risk of CP.

The researchers conclude that "exposure to pre-eclampsia was associated with an increased risk of CP […] and this was also increased in children born small for gestational age". They add that as delivery of a pre-eclamptic pregnancy is mostly related to the health of the mother or severe growth restriction, early signs of a smaller than average baby should be taken into account. They say further studies are warranted.

In a video abstract, authors Kirstin Melheim Strand and Torstein Vik explain that pre-eclampsia and low birth weight are important risk factors for . They conclude that they "found that pre-eclampsia is a risk factor for cerebral palsy mainly mediated through pre-term birth and " and that they found "no direct effect of pre-eclampsia on the risk of cerebral palsy".

More information: www.bmj.com/cgi/doi/10.1136/bmj.f4089

Related Stories

Obesity increases the risk of preterm delivery

date Jun 11, 2013

The risk of preterm delivery increases with maternal overweight and obesity, according to a new Swedish study published in Journal of the American Medical Association (JAMA). Women with the highest Body Mass Index (BMI) a ...

Recommended for you

An explanation of wild birds' role in avian flu outbreak

date 1 hour ago

Wild birds are believed to be behind the first major widespread outbreak of bird flu in the United States, with the virus confirmed in the animals in 10 states. Here are some questions and answers about how wild birds remain ...

Gastroenterology Special Issue confirms: You are what you eat

date 4 hours ago

Patients are always interested in understanding what they should eat and how it will impact their health. Physicians are just as interested in advancing their understanding of the major health effects of foods and food-related ...

Gonorrhoea and syphilis in Norway in 2014

date 6 hours ago

Reported cases of gonorrhea continue to increase in Norway, both among men who have sex with men (MSM) and among heterosexuals. The increase of gonorrhea among heterosexual women was particularly significant. ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.