PT  - JOURNAL ARTICLE
AU  - Marefi, Amaar
AU  - Husein, Nafisa
AU  - Dunbar, Mary
AU  - Dewey, Deborah
AU  - Letourneau, Nicole
AU  - Oskoui, Maryam
AU  - Kirton, Adam
AU  - Shevell, Michael I.
AU  - ,
TI  - Risk Factors for Term-Born Periventricular White Matter Injury in Children With Cerebral Palsy
AID  - 10.1212/WNL.0000000000201274
DP  - 2022 Nov 29
TA  - Neurology
PG  - e2485--e2493
VI  - 99
IP  - 22
4099  - http://n.neurology.org/content/99/22/e2485.short
4100  - http://n.neurology.org/content/99/22/e2485.full
SO  - Neurology2022 Nov 29; 99
AB  - Objective The aim of this study was to identify possible risk factors associated with term-born children with cerebral palsy (CP) and periventricular white matter injury (PVWMI) on imaging.Methods This is a case-controlled study restricted to term-born children with CP with the cases extracted from the Canadian Cerebral Palsy Registry and controls from Alberta Pregnancy Outcomes and Nutrition (APrON) study. A diagnosis of PVWMI was performed based on expert categorization of MRI reports. Risk factor variables were selected a priori; these included pregnancy complications, antenatal toxin exposure, perinatal infection, sex, small for gestational age, and perinatal adversity (i.e., neonatal encephalopathy presumably on the basis of intrapartum hypoxia-ischemia). We used multivariable analyses to calculate odds ratios (ORs) and their 95% CIs.Results A total of 160 cases (7.06% of the registry sample) were compared with 1,950 controls. Of the term-born PVWMI participants, 59.4% were male and 13.5% were born to mothers of extreme maternal age. Multivariable analysis of each risk factor controlled for weight showed PVWMI is associated with pregnancy complications (OR = 3.35; 95% CI = 2.23–4.94), antenatal toxin exposure (OR = 2.45; 95% CI = 1.67–3.55), perinatal infection (OR = 3.61; 95% CI = 1.96–6.29), and perinatal adversity (OR = 2.03; 95% CI = 1.42–2.94). Term-born male participants were not more likely to experience PVWMI compared with female participants (OR = 1.37; 95% CI = 0.98–1.93). Multiple regression analyses suggested independent associations between PVWMI and pregnancy complications (OR = 3.75; 95% CI 2.46–5.62), antenatal toxin exposure (OR = 2.80; 95% CI 1.88–4.12), perinatal infection (OR = 4.62; 95% CI 2.46–8.42), and perinatal adversity (OR = 2.49; 95% CI = 1.71–3.69).Discussion Risk factors such as pregnancy complications, antenatal toxin exposure, perinatal infection, and perinatal adversity are associated with PVWMI in term-born children, suggesting perhaps variable interactions between antenatal and perinatal factors to yield this under-recognized CP phenotype.APrON=Alberta Pregnancy Outcomes and Nutrition; CCPR=Canadian Cerebral Palsy Registry; CP=cerebral palsy; GMFCS=gross motor function classification system; MACS=manual ability classification system; OR=odds ratio; PVWMI=periventricular white matter injury