Cerebral palsy: Evaluation of a model of risk

Abstract

The purpose of this study was to assess a model of risk for cerebral palsy (CP) in preschool children. The research was structured as a retrospective case-control study in which cases (n = 112) were children with CP while controls (n = 153) were either friend referrals or population-based. Data were collected via structured telephone interviews. While significant associations with CP were found on univariate analyses for a number of variables, only four variables--birth weight/gestational age, 5-min APGAR, medication for miscarriage, and urinary tract infection during pregnancy--were found predictive in multivariate analysis. These variables accounted for 36% of the log-likelihood explained by the model.

Urinary Tract Infection During Pregnancy: A Risk Factor for Cerebral Palsy?

“…Palmer et al (1995) reported no link between UTI and moderate and severe CP cases in western Australia. In contrast, Polivka et al (1993) reported detection of an association with UTI in a case-control study assessing the relationship of multiple factors (e.g., environmental exposures, parental health, pregnancy complications, and maternal lifestyle) to CP risk.…”

“…Low birth weight, small for gestational age (SGA), intrauterine growth retardation, and previous fetal loss also have been linked consistently to increased risk for CP. Low birth weight and SGA have been cited as the most important and consistent known factors related to CP development (Jonas, Stern, & Macharper, 1989;Nelson & Ellenberg, 1985;Polivka et al, 1993). Other factors associated with CP development and prenatal maternal UTI include number of prenatal visits, socioeconomic status, maternal age, and parity (Andriole & Patterson, 1991; Stenqvist et al, 1989).…”

“…The purposes of this secondary analysis are (a) to analyze more specifically a previously reported (Polivka, Nickel, & Wilkins, 1993) association between an antenatal event, maternal urinary tract infection (UTI) during pregnancy, and CP risk, controlling for potential confounding effects of birth weight and gestational age; and (b) to identify additional confounders for the association between UTI and CP. Although physiologic evidence supporting a link between UTI and CP risk is reviewed, the purpose of this study is to clarify identified risk factors for CP.…”

Risk Factors for Cerebral Palsy

“…These variables are congenital malformations (21,(34)(35)(36), multiple pregnancy (37)(38)(39), unhealthy placenta and placenta previa (21,4041), abnormal amniotic fluid (19,21), prematurity (6,8,18,42), low birthweight for gestational age (7,8,10,11,24,42), large head circumference at birth ( 11,28,43) and forceps delivery (8). Birth trauma and birth asphyxia have also been reported as determinants of CP, but there is no agreement about their quantitative importance (4,5,8,20,21,26,(44)(45)(46)(47)(48)(49). Moreover, it cannot be documented with certainty in case-control studies whether statistical associations between either of these variables and CP reflect disease causation, uncontrollable information bias or consequences of the disease.…”

“…Several major epidemiologic studies have been undertaken during the last twenty years in the USA, UK, Sweden and Australia (5,(18)(19)(20)(21) but there is a paucity of data from specifically designed studies concerning the etiology of the disease in other parts of the world, including countries of Central and Southern Europe. Since CP is likely to be an entity of heterogeneous etiology, studies in several populations are needed to reveal the spectrum of possible risk factors; moreover, it is possible that studies in certain population groups may be inherently more powerful than those in others on account of higher…”