Chorioamnionitis and Cerebral Palsy in Term and Near-Term Infants

摘要: ContextHalf of all cases cerebral palsy (CP) occur in term infants, for whom risk factors have not been clearly defined. Recent studies suggest a possible role chorioamnionitis.ObjectiveTo determine whether clinical chorioamnionitis increases the of CP and near-term infants.Design, Setting, PatientsCase-control study nested within a cohort 231 582 singleton infants born at 36 or more weeks' gestation between January 1, 1991, December 31, 1998, Kaiser Permanente Medical Care Program, managed care organization providing for than 3 million residents northern California. Case patients were identified from electronic records confirmed by chart review by child neurologist, comprised children with moderate to severe spastic dyskinetic CP due postnatal brain injury developmental abnormalities (n = 109). Controls 218) randomly selected the study population.Main Outcome MeasureAssociation increased infants.ResultsMost had hemiparesis (40%) quadriparesis (38%); 87% had been diagnosed neurologist 83% undergone neuroimaging. Chorioamnionitis, considered present if treating physician made diagnosis chorioamnionitis or endometritis clinically, was noted 14% 4% controls (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.5-10.1; P .001). Independent multiple logistic regression included (OR, 4.1; CI, 1.6-10.1), intrauterine growth restriction 4.0; 1.3-12.0), maternal black ethnicity (OR, 3.6; 1.4-9.3), age older 25 years 2.6; CI, 1.3-5.2), nulliparity 1.8; 1.0-3.0). The population-attributable fraction is 11%.ConclusionOur data that an independent factor for among infants.