Neonatal Infection in Children with Cerebral Palsy: a Registry-Based Cohort Study

Publication date: Available online 13 December 2017
Source:Pediatric Neurology
Author(s): Anne-Sophie Smilga, Jarred Garfinkle, Pamela Ng, John Andersen, David Buckley, Darcy Fehlings, Adam Kirton, Ellen Wood, Esias van Rensburg, Michael Shevell, Maryam Oskoui
ObjectiveThe goal of this study was to explore the association between neonatal infection and outcomes in children with cerebral palsy (CP).MethodsWe conducted a retrospective cohort study using the Canadian CP Registry. Neonatal infection was defined as meeting one of the following criteria: 1) septicemia, 2) septic shock, or 3) administration of antibiotics for ≥ 10 days. Phenotypic profiles of children with CP with and without an antecedent neonatal infection were compared. Sub-group analysis was performed, stratified by gestational age (term vs. preterm).ResultsOf the 1229 registry participants, 505 (41.1%) were preterm, and 192 (15.6%) met criteria for neonatal infection with 29% of preterm children having a neonatal infection compared to 6.5% in term-born children. Children with prior neonatal infection were more likely to have a white matter injury (OR 2.2, 95% CI 1.5-3.2), spastic diplegic neurological subtype (OR 1.6, 95% CI 1.1-2.3), and sensorineural auditory impairment (OR 2.1, 95% CI 1.4-3.3). Amongst preterm children, neonatal infection was not associated with a difference in phenotypic profile. Term-born children with neonatal infection were more likely to have spastic triplegia or quadriplegia (OR 2.4, 95% CI 1.3-4.3), concomitant white matter and cortical injury (OR 4.1, 95% CI 1.6-10.3), and more severe gross motor ability [Gross Motor Function Classification System IV-V](OR 2.6, 95% CI 1.4-4.8) compared to preterm children.ConclusionsFindings suggest a role of systemic infection on the developing brain in term-born infants, and the possibility to develop targeted therapeutic and preventive strategies to reduce CP morbidity.



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