Cerebral palsy risk up with exposure to maternal unintentional injury in utero

Exposure to maternal injury in utero is associated with increased risk of cerebral palsy (CP), according to a study published online Nov. 28 in JAMA Pediatrics.

Asma Ahmed, M.D., Ph.D., M.P.H., from McGill University in Montreal, and colleagues examined the association between maternal unintentional injury and CP in offspring in a population-based, longitudinal cohort study. Infants born between April 1, 2002, and March 31, 2017, at more than 20 weeks of gestation were included.

Data were included for 2,110,177 children; 81.281 (3.9 percent) were exposed to maternal unintentional injury in utero. The researchers found that 5,317 children (0.3 percent) were diagnosed with CP during a median follow-up of eight years; 292 CP cases (5.5 percent) were exposed to maternal unintentional injury. In the exposed and unexposed groups, the mean incidence rates of CP were 4.36 and 2.93 per 10,000 child-years, respectively. After adjustment for maternal sociodemographic and clinical characteristics, there was a modest increase in the risk of CP for children exposed to maternal unintentional injury compared with those who were unexposed (hazard ratio, 1.33). Higher risks of CP were seen for severe injuries that resulted in hospitalization and delivery within one week from the injury (adjusted hazard ratios, 2.18 and 3.40, respectively).

"These results suggest that monitoring of children exposed to maternal injury in utero may contribute to early detection of adverse neurodevelopmental outcomes and thus to the provision of optimal management and needed support," the authors write.

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