Maternal Chronic Conditions and Risk of Cerebral Palsy in Offspring: A National Cohort Study

Abstract

BACKGROUND AND OBJECTIVES: Previous studies suggest that children of mothers with certain chronic conditions may be at increased risk of cerebral palsy (CP). We explored possible associations between 17 maternal chronic conditions and CP in offspring. METHODS: We conducted a prospective cohort study of Norwegian children born in 1990–2012 and surviving to 2 years of age. Information on maternal chronic conditions during pregnancy were extracted from the Medical Birth Registry of Norway (1990–2012). Information on chronic conditions in mothers and fathers recorded in the Norwegian Patient Registry (2008–2014) was available for a subset of children. CP diagnoses were extracted from the National Insurance Scheme (1990–2014) and the Norwegian Patient Registry (2008–2014). We estimated relative risks (RRs) and 95% confidence intervals (CIs) of CP in offspring of parents with chronic conditions compared with the general population using log binominal regression models. RESULTS: A total of 1 360 149 Norwegian children, including 3575 children with CP (2.6 per 1000 live births), fulfilled the inclusion criteria. The highest risk of CP was among offspring of mothers with type 2 diabetes (RR 3.2; 95% CI 1.8–5.4), lupus erythematosus (RR 2.7; 95% CI 0.9–8.3), type 1 diabetes (RR 2.2; 95% CI 1.4–3.4), and Crohn disease (RR 2.1; 95% CI 1.0–4.1) during pregnancy. No increased risks were seen for offspring of fathers with chronic conditions. CONCLUSIONS: Several maternal chronic conditions were associated with increased risk of CP in offspring. Maternal autoimmune disorders carried a particular risk.