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

Polivka, Barbara; Nickel, Jennie T.; Wilkins, J. R.

doi:10.1111/j.1552-6909.1997.tb02722.x

Cited by 41 publications

(20 citation statements)

References 36 publications

(34 reference statements)

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“…Este resultado merece destaque quando levamos em consideração os vári-os artigos que têm abordado as conseqüências da infecção materna durante o período de gestação para o feto. A infecção materna representa um risco de infecção para o feto e parece tornar o RN prematuro particularmente vulnerável a danos neurológicos [12][13][14][15][16][17][18] .…”

Section: Resultsunclassified

Hyperechogenicity of thalamic vessels in preterm newborn infants

Paczko¹,

Rotta²,

Silva³

et al. 2002

J Pediatr (Rio J)

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Objective: the aim of this study is to evaluate possible pathologies associated with hyperechogenicity of thalamic vessels (HETV), which are found on brain ultrasounds (BUS), as well as to observe the frequency of their occurrence.Methods: the sample was composed of 206 preterm newborn infants at Hospital de Clíncas de Porto Alegre (HCPA) from July 1998 to May 1999. All of them were submitted to BUS in the first week of life. Preterm children who needed hospital admission and had a term of informed consent signed up by their guardians were included in this study. Preterm newborn children with BUS showing intracranial hemorrhage and/or associated congenital malformation were excluded from this study.Results: through BUS it was possible to identify 65 preterm newborn children with HETV and 141 preterm newborn children without HETV.Conclusions: we identified the following risk factors for HETV: pelvic presentation, longer gestational period, increased birthweight and big for gestational age classification. On the other hand, mothers hypertension during the gestational period tended to protect infants from HETV. The newborn infants that presented convulsive crises during hospitalization had a 3.2-fold higher risk of having HETV when compared to the ones who did not go through any convulsive crises.J Pediatr (Rio J) 2002; 78 (5): 371-4: brain ultrasound, preterm, hyperechogenicity of thalamic vessels. ResumoObjetivo: o presente estudo procura avaliar as possíveis patologias que se manifestam associadas à hiperecogenicidade dos vasos talâmicos na ultra-sonografia cerebral, e observar a freqüência com que ocorrem.Métodos: a amostra foi constituída de 206 recém-nascidos prematuros, nascidos no Hospital de Clínicas de Porto Alegre, no período de julho de 1998 a maio de 1999. Todos realizaram a ultrasonografia cerebral na primeira semana de vida. Foram incluídos no estudo aqueles prematuros que necessitaram de internação hospitalar, e que tiveram o termo de consentimento informado assinado por um dos responsáveis. Foram excluídos aqueles cuja ultra-sonografia cerebral evidenciava sangramento cerebral e/ou malformações congênitas associadas, e os que evoluíram para óbito antes da realização do exame.Resultados: a ultra-sonografia cerebral levou à identificação de 65 recém-nascidos prematuros com hiperecogenicidade dos vasos talâmicos e de 141 recém-nascidos prematuros sem.Conclusões: a forma de apresentação do tipo pélvica ao nascimento, a maior idade gestacional, o maior peso do recém-nascido ao nascimento e a classificação grande para a idade gestacional foram fatores de risco para a ocorrência de hiperecogenicidade dos vasos talâmicos, enquanto a presença de hipertensão materna durante o período de gestação tendeu a ser fator de proteção. Os recém-nascidos que apresentaram crises convulsivas durante o período de internação hospitalar tiveram risco 3,2 vezes maior de ter hiperecogenicidade dos vasos talâmicos, quando comparados aos que não apresentaram crises convulsivas.J Pediatr (Rio J) 2002; 78 (5): 371-4: ult...

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Section: Resultsunclassified

Hyperechogenicity of thalamic vessels in preterm newborn infants

Paczko¹,

Rotta²,

Silva³

et al. 2002

J Pediatr (Rio J)

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“…Evidence for heterogeneity was found among studies without specific diagnostic criteria (test of homogeneity, P ϭ 0.08). Five studies examining the risk of maternal fever alone [Eastman and DeLeon, 1955;Perlman et al, 1996;Polivka et al, 1997;Leviton et al, 1999;Grether and Nelson, 2000] were also statistically heterogeneous (test of homogeneity, P ϭ 0.004). The five studies that required the most stringent criteria (at least 3 signs/symptoms suggestive of clinical chorioamnionitis) produced remarkably homogeneous results (individual study RR's ranging from 2.1-3.0).…”

Section: Stratified Analysis In Preterm Infantsmentioning

confidence: 94%

Systematic review of chorioamnionitis and cerebral palsy

2002

Ment. Retard. Dev. Disabil. Res. Rev.

212

126

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In a recent meta-analysis evaluating the relationship between chorioamnionitis and cerebral palsy, we found that chorioamnionitis is a risk factor for both cerebral palsy and cystic periventricular leukomalacia (cPVL). The current paper extends the meta-analysis by including studies published in the year 2000, and by further evaluating the causes of heterogeneity among individual study results. Using a random effects model, clinical chorioamnionitis was significantly associated with both cerebral palsy (RR 1.9, 95% CI 1.5-2.5) and cPVL (RR 2.6, 95% CI 1.7-3.9). Sources of heterogeneity included widely varying practices in the diagnosis of clinical chorioamnionitis, different gestational age characteristics, and varying study year. We conclude that based on the available literature, chorioamnionitis is a risk factor for both cerebral palsy and cPVL.

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“…Therefore, there is a great deal of heterogeneity between studies regarding the association between these infections and the risk of preterm birth (Beck et al, 2010). Among other recognized perinatal complications of UTI, we highlight premature rupture of membranes, intrauterine growth restriction, cerebral palsy/mental retardation and perinatal death (Romero et al, 1989;Polivka et al, 1997;McDermott et al, 2000;Duarte et al, 2008). Some cases of periventricular leukomalacia and fetal septicemia have been recently reported as a result of transplacental transfer of cytokines originated from maternal UTIs (Spinillo et al, 1998;Oda et al, 2008).…”

Section: Utis and Perinatal Outcomesmentioning

confidence: 99%