%0 Journal Article %1 Wu2003 %A Wu, Yvonne W %A Escobar, Gabriel J %A Grether, Judith K %A Croen, Lisa A %A Greene, John D %A Newman, Thomas B %D 2003 %J JAMA %K Asphyxia Neonatorum; Case-Control Studies; Cerebral Palsy; Chorioamnionitis; Female; Humans; Infant; Infant, Newborn; Pregnancy; Risk Factors %N 20 %P 2677--2684 %R 10.1001/jama.290.20.2677 %T Chorioamnionitis and cerebral palsy in term and near-term infants. %U http://dx.doi.org/10.1001/jama.290.20.2677 %V 290 %X CONTEXT: Half of all cases of cerebral palsy (CP) occur in term infants, for whom risk factors have not been clearly defined. Recent studies suggest a possible role of chorioamnionitis. OBJECTIVE: To determine whether clinical chorioamnionitis increases the risk of CP in term and near-term infants. DESIGN, SETTING, AND PATIENTS: Case-control study nested within a cohort of 231 582 singleton infants born at 36 or more weeks' gestation between January 1, 1991, and December 31, 1998, in the Kaiser Permanente Medical Care Program, a managed care organization providing care for more than 3 million residents of northern California. Case patients were identified from electronic records and confirmed by chart review by a child neurologist, and comprised all children with moderate to severe spastic or dyskinetic CP not due to postnatal brain injury or developmental abnormalities (n = 109). Controls (n = 218) were randomly selected from the study population. MAIN OUTCOME MEASURE: Association between clinical chorioamnionitis and increased risk of CP in term and near-term infants. RESULTS: Most CP cases had hemiparesis (40\%) or quadriparesis (38\%); 87\% had been diagnosed by a neurologist and 83\% had undergone neuroimaging. Chorioamnionitis, considered present if a treating physician made a diagnosis of chorioamnionitis or endometritis clinically, was noted in 14\% of cases and 4\% of controls (odds ratio OR, 3.8; 95\% confidence interval CI, 1.5-10.1; P =.001). Independent risk factors identified in multiple logistic regression included chorioamnionitis (OR, 4.1; 95\% CI, 1.6-10.1), intrauterine growth restriction (OR, 4.0; 95\% CI, 1.3-12.0), maternal black ethnicity (OR, 3.6; 95\% CI, 1.4-9.3), maternal age older than 25 years (OR, 2.6; 95\% CI, 1.3-5.2), and nulliparity (OR, 1.8; 95\% CI, 1.0-3.0). The population-attributable fraction of chorioamnionitis for CP is 11\%. CONCLUSION: Our data suggest that chorioamnionitis is an independent risk factor for CP among term and near-term infants.

@article{Wu2003, abstract = {CONTEXT: Half of all cases of cerebral palsy (CP) occur in term infants, for whom risk factors have not been clearly defined. Recent studies suggest a possible role of chorioamnionitis. OBJECTIVE: To determine whether clinical chorioamnionitis increases the risk of CP in term and near-term infants. DESIGN, SETTING, AND PATIENTS: Case-control study nested within a cohort of 231 582 singleton infants born at 36 or more weeks' gestation between January 1, 1991, and December 31, 1998, in the Kaiser Permanente Medical Care Program, a managed care organization providing care for more than 3 million residents of northern California. Case patients were identified from electronic records and confirmed by chart review by a child neurologist, and comprised all children with moderate to severe spastic or dyskinetic CP not due to postnatal brain injury or developmental abnormalities (n = 109). Controls (n = 218) were randomly selected from the study population. MAIN OUTCOME MEASURE: Association between clinical chorioamnionitis and increased risk of CP in term and near-term infants. RESULTS: Most CP cases had hemiparesis (40\%) or quadriparesis (38\%); 87\% had been diagnosed by a neurologist and 83\% had undergone neuroimaging. Chorioamnionitis, considered present if a treating physician made a diagnosis of chorioamnionitis or endometritis clinically, was noted in 14\% of cases and 4\% of controls (odds ratio [OR], 3.8; 95\% confidence interval [CI], 1.5-10.1; P =.001). Independent risk factors identified in multiple logistic regression included chorioamnionitis (OR, 4.1; 95\% CI, 1.6-10.1), intrauterine growth restriction (OR, 4.0; 95\% CI, 1.3-12.0), maternal black ethnicity (OR, 3.6; 95\% CI, 1.4-9.3), maternal age older than 25 years (OR, 2.6; 95\% CI, 1.3-5.2), and nulliparity (OR, 1.8; 95\% CI, 1.0-3.0). The population-attributable fraction of chorioamnionitis for CP is 11\%. CONCLUSION: Our data suggest that chorioamnionitis is an independent risk factor for CP among term and near-term infants.}, added-at = {2014-07-20T09:28:28.000+0200}, author = {Wu, Yvonne W and Escobar, Gabriel J and Grether, Judith K and Croen, Lisa A and Greene, John D and Newman, Thomas B}, biburl = {https://www.bibsonomy.org/bibtex/2489e64d22cebb97a1c82251e93f32477/ar0berts}, doi = {10.1001/jama.290.20.2677}, groups = {public}, interhash = {532e3031630f955f74b5e09c680d6d3f}, intrahash = {489e64d22cebb97a1c82251e93f32477}, journal = {JAMA}, keywords = {Asphyxia Neonatorum; Case-Control Studies; Cerebral Palsy; Chorioamnionitis; Female; Humans; Infant; Infant, Newborn; Pregnancy; Risk Factors}, month = Nov, number = 20, pages = {2677--2684}, pii = {290/20/2677}, pmid = {14645309}, timestamp = {2014-07-20T09:29:15.000+0200}, title = {Chorioamnionitis and cerebral palsy in term and near-term infants.}, url = {http://dx.doi.org/10.1001/jama.290.20.2677}, username = {ar0berts}, volume = 290, year = 2003 }