Email updates

Keep up to date with the latest news and content from BMC Pregnancy and Childbirth and BioMed Central.

Open Access Research article

Cerebral palsy and placental infection: a case-cohort study

Rasiah Vigneswaran1, Stacey J Aitchison2, Helen M McDonald3, T Yee Khong4 and Janet E Hiller2*

Author Affiliations

1 Department of Neonatology, Women's and Children's Hospital (WCH), 72 King William Road, North Adelaide, South Australia, Australia 5006

2 Department of Public Health, University of Adelaide, 5005 Australia

3 Department of Microbiology and Infectious Diseases, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, Australia 5006

4 Department of Histopathology, Women's and Children's Hospital 72 King William Road, North Adelaide, South Australia, Australia 5006

For all author emails, please log on.

BMC Pregnancy and Childbirth 2004, 4:1  doi:10.1186/1471-2393-4-1

Published: 27 January 2004

Abstract

Background

The association between cerebral palsy in very preterm infants and clinical, histopathologic and microbiological indicators of chorioamnionitis, including the identification of specific micro-organisms in the placenta, was evaluated in a case-cohort study.

Methods

Children with a diagnosis of cerebral palsy at five years of age were identified from amongst participants in a long-term follow-up program of preterm infants. The comparison group was a subcohort of infants randomly selected from all infants enrolled in the program. The placentas were examined histopathologically for chorioamnionitis and funisitis, and the chorioamnionic interface was aseptically swabbed and comprehensively cultured for aerobic and anaerobic bacteria, yeast and genital mycoplasmas. Associations between obstetric and demographic variables, indicators of chorioamnionitis and cerebral palsy status were examined by univariate analysis.

Results

Eighty-two infants with cerebral palsy were compared with the subcohort of 207 infants. Threatened preterm labor was nearly twice as common among the cases as in the subcohort (p < 0.01). Recorded clinical choroamnionitis was similar in the two groups and there was no difference in histopathologic evidence of infection between the two groups. E. coli was cultured from the placenta in 6/30 (20%) of cases as compared with 4/85 (5%) of subcohort (p = 0.01). Group B Streptococcus was more frequent among the cases, but the difference was not statistically significant.

Conclusions

The association between E. coli in the chorioamnion and cerebral palsy in preterm infants identified in this study requires confirmation in larger multicenter studies which include microbiological study of placentas.

Keywords:
cerebral palsy; placenta; chorioamnionitis; Escherichia coli