We tested the hypothesis that term and preterm infants exposed to maternal infection at the time of delivery are at increased risk of developing cerebral palsy (CP). STUDY DESIGN:A population-based case-control study was conducted using Washington State birth certificate data linked to hospital discharge data. Cases (688) were children r6 years old, singleton births, hospitalized during 1987 to 1999 with an ICD-9 diagnosis code for CP. Controls were 3068 singleton birth infants randomly selected from birth records for the same years without CP-related hospitalizations. Infection information was available only for the birth hospitalization. RESULTS:Infants of women who had any infection during their hospitalization for delivery were at increased risk of CP (odds ratio (OR) 3.1, 95% confidence interval (CI) 2.3 to 4.2). This was observed for term deliveries (OR 1.8, 95% CI 1.1 to 2.8) and preterm deliveries (OR 2.3, 95% CI 1.3 to 4.2). CONCLUSIONS:Our results suggest that maternal infection is a risk factor for CP in both term and preterm infants.

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Objective-Gaps in health insurance coverage compromise access to health care services, but it is unclear whether the length of time without coverage is an important factor. This article examines how coverage gaps of different lengths affect access to health care among low-income children.Methods-We conducted a multivariable, cross-sectional analysis of statewide primary data from families in Oregon's food stamp population with children presumed eligible for publicly funded health insurance. The key independent variable was length of a child's insurance coverage gap; outcome variables were 6 measures of health care access.Results-More than 25% of children reported a coverage gap during the 12-month study period. Children most likely to have a gap were older, Hispanic, lived in households earning between 133% and 185% of the federal poverty level, and/or had an employed parent. After adjusting for these characteristics, in comparison with continuously insured children, a child with a gap of any length had a higher likelihood of unmet medical, prescription, and dental needs; no usual source of care; no doctor visits in the past year; and delayed urgent care. When comparing coverage gaps, children without coverage for longer than 6 months had a higher likelihood of unmet needs compared with children with a gap shorter than 6 months. In some cases, children with gaps longer than 6 months were similar to, or worse off than, children who had never been insured.Conclusions-State policies should be designed to minimize gaps in public health insurance coverage in order to ensure children's continuous access to necessary services. Keywords HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptPoint-in-time estimates reveal that approximately 9 million children are without health insurance. When including children with gaps in coverage during the year, the number of uninsured children almost doubles. -Although many uninsured children are eligible for public insurance programs, children are more likely than adults to have episodes without coverage. -Therefore, it is crucial to study how these health insurance coverage gaps affect access to health care, especially among children eligible for Medicaid and the State Children's Health Insurance Program (SCHIP).Current reports are mixed about how insurance gaps affect children's access to care. Gaps are associated with discontinuities in receipt of recommended primary care and a higher likelihood of delayed medical care. -In contrast, some evidence suggests that insurance gaps do not predict worsening of specific outcome markers, such as emergency department utilization rates or hospitalization for asthma. , Less is known about how the duration of time without coverage affects health care access for low-income children.Establishing the significance of the length of time without insurance among children eligible for public coverage has important policy implications. Oregon is a key state to highlight in this endeavor because Oregon has a...