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Intrauterine drug exposure as a risk factor for cerebral palsy

Title: Intrauterine drug exposure as a risk factor for cerebral palsy
Authors: Benninger, Kristen L; Purnell, Jessica; Conroy, Sara; Jackson, Kenneth; Batterson, Nancy; Neel, Mary Lauren; Hester, Mark E; Maitre, Nathalie L
Contributors: Cerebral Palsy Foundation; Eunice Kennedy Shriver National Institute of Child Health and Human Development
Source: Developmental Medicine & Child Neurology ; volume 64, issue 4, page 453-461 ; ISSN 0012-1622 1469-8749
Publisher Information: Wiley
Publication Year: 2021
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Aim To determine whether infants with intrauterine drug exposure (IUDE) are similarly at risk for cerebral palsy (CP) as other high‐risk populations, whether CP classification differs based on IUDE status, and describe the association of CP with specific substances among exposed infants. Method This was a retrospective analysis of infants in a high‐risk follow‐up program ( n =5578) between January 2014 and February 2018 with a history of IUDE or who received a CP diagnosis. CP rates were compared using two‐sample z ‐tests. CP classification was assessed using Fisher’s exact, Cochran–Armitage, and Wilcoxon rank‐sum tests. Models for CP risk were assessed using multivariable logistic regression. Results Among all infants with IUDE ( n =1086), 53.8% were male with a mean (SD) birth gestational age of 36.8 (3.6) weeks. Among unexposed infants with CP ( n =259), 54.4% were male with a mean (SD) birth gestational age of 29.9 (5.7) weeks. Opioids were the most common exposure (93.7%) of all infants with IUDE. The CP rate in the IUDE (5.2%) and unexposed (5.7%) high‐risk populations were not significantly different ( p =0.168), nor were there differences in CP typology, topography, or severity between exposed ( n =57) and unexposed ( n =259) infants (all p >0.05). In patients with IUDE and after controlling for established CP risk factors, the observed odds of CP varied among substances. Interpretation We suggest that IUDE should be considered a ‘newborn‐detectable risk’ in the guidelines for the early detection of CP.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/dmcn.15050
Availability: https://doi.org/10.1111/dmcn.15050; https://onlinelibrary.wiley.com/doi/pdf/10.1111/dmcn.15050; https://onlinelibrary.wiley.com/doi/full-xml/10.1111/dmcn.15050
Rights: http://onlinelibrary.wiley.com/termsAndConditions#vor
Accession Number: edsbas.4EE88DFC
Database: BASE