To Örebro University

Introduction: Cerebral palsy (CP) is a lifelong disorder with a high rate of comorbidities and complications. We hypothesized that women with CP are at increased risk of adverse pregnancy outcome.

Material and methods: In this nationwide population-based cohort study 1997-2011, we examined the outcome of 770 births in women with CP vs 1 247 408 births in women without a CP diagnosis using the Swedish Medical Birth Register. We used unconditional logistic regression, adjusting for maternal age, smoking, parity, year of birth and epilepsy, to calculate adjusted odds ratios for adverse pregnancy outcome. Main adverse outcome was preterm birth. Secondary outcomes were cesarean section, induction of labor, low 5-min Apgar score, small for gestational age, large for gestational age, and stillbirth.

Results: After adjusting for potential confounders, maternal CP was associated with increased risk of preterm birth (12.9% vs 4.9%; adjusted odds ratio [aOR] 2.8, 95% CI 2.3-3.5), cesarean delivery (aOR 1.9, 95% CI 1.6-2.2), induced delivery (aOR 1.4, 95% CI 1.1-1.6), low 5-min Apgar score (aOR 1.8, 95% CI 1.1-2.9) and small of gestational age birth (aOR 1.6, 95% CI 1.2-2.3). We found no increased risk of large for gestational age or stillbirth.

Conclusions: Women with CP are at increased risk of preterm birth and other adverse pregnancy outcomes, suggesting that they deserve extra surveillance during antenatal care. Further studies, with information on type of CP and gross motor function, are warranted to better understand the association between CP and pregnancy outcome.