RT Journal Article
SR Electronic
T1 Risk Factors for Term-Born Periventricular White Matter Injury in Children With Cerebral Palsy
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP e2485
OP e2493
DO 10.1212/WNL.0000000000201274
VO 99
IS 22
A1 Marefi, Amaar
A1 Husein, Nafisa
A1 Dunbar, Mary
A1 Dewey, Deborah
A1 Letourneau, Nicole
A1 Oskoui, Maryam
A1 Kirton, Adam
A1 Shevell, Michael I.
A1 ,
YR 2022
UL http://n.neurology.org/content/99/22/e2485.abstract
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