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Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis

OBJECTIVES: To assess the incidence of cerebral palsy among children born to mothers who had their pregnancy complicated by a motor vehicle crash. DESIGN: Retrospective longitudinal cohort analysis of children born from 1 April 2002 to 31 March 2012 in Ontario, Canada. PARTICIPANTS: Cases defined as...

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Autores principales: Redelmeier, Donald A, Naqib, Faisal, Thiruchelvam, Deva, R Barrett, Jon F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051428/
https://www.ncbi.nlm.nih.gov/pubmed/27650764
http://dx.doi.org/10.1136/bmjopen-2016-011972
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author Redelmeier, Donald A
Naqib, Faisal
Thiruchelvam, Deva
R Barrett, Jon F
author_facet Redelmeier, Donald A
Naqib, Faisal
Thiruchelvam, Deva
R Barrett, Jon F
author_sort Redelmeier, Donald A
collection PubMed
description OBJECTIVES: To assess the incidence of cerebral palsy among children born to mothers who had their pregnancy complicated by a motor vehicle crash. DESIGN: Retrospective longitudinal cohort analysis of children born from 1 April 2002 to 31 March 2012 in Ontario, Canada. PARTICIPANTS: Cases defined as pregnancies complicated by a motor vehicle crash and controls as remaining pregnancies with no crash. MAIN OUTCOME: Subsequent diagnosis of cerebral palsy by age 3 years. RESULTS: A total of 1 325 660 newborns were analysed, of whom 7933 were involved in a motor vehicle crash during pregnancy. A total of 2328 were subsequently diagnosed with cerebral palsy, equal to an absolute risk of 1.8 per 1000 newborns. For the entire cohort, motor vehicle crashes correlated with a 29% increased risk of subsequent cerebral palsy that was not statistically significant (95% CI −16 to +110, p=0.274). The increased risk was only significant for those with preterm birth who showed an 89% increased risk of subsequent cerebral palsy associated with a motor vehicle crash (95% CI +7 to +266, p=0.037). No significant increase was apparent for those with a term delivery (95% CI −62 to +79, p=0.510). A propensity score-matched analysis of preterm births (n=4384) yielded a 138% increased relative risk of cerebral palsy associated with a motor vehicle crash (95% CI +27 to +349, p=0.007), equal to an absolute increase of about 10.9 additional cases per 1000 newborns (18.2 vs 7.3, p=0.010). CONCLUSIONS: Motor vehicle crashes during pregnancy may be associated with an increased risk of cerebral palsy among the subgroup of cases with preterm birth. The increase highlights a specific role for traffic safety advice in prenatal care.
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spelling pubmed-50514282016-10-17 Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis Redelmeier, Donald A Naqib, Faisal Thiruchelvam, Deva R Barrett, Jon F BMJ Open Obstetrics and Gynaecology OBJECTIVES: To assess the incidence of cerebral palsy among children born to mothers who had their pregnancy complicated by a motor vehicle crash. DESIGN: Retrospective longitudinal cohort analysis of children born from 1 April 2002 to 31 March 2012 in Ontario, Canada. PARTICIPANTS: Cases defined as pregnancies complicated by a motor vehicle crash and controls as remaining pregnancies with no crash. MAIN OUTCOME: Subsequent diagnosis of cerebral palsy by age 3 years. RESULTS: A total of 1 325 660 newborns were analysed, of whom 7933 were involved in a motor vehicle crash during pregnancy. A total of 2328 were subsequently diagnosed with cerebral palsy, equal to an absolute risk of 1.8 per 1000 newborns. For the entire cohort, motor vehicle crashes correlated with a 29% increased risk of subsequent cerebral palsy that was not statistically significant (95% CI −16 to +110, p=0.274). The increased risk was only significant for those with preterm birth who showed an 89% increased risk of subsequent cerebral palsy associated with a motor vehicle crash (95% CI +7 to +266, p=0.037). No significant increase was apparent for those with a term delivery (95% CI −62 to +79, p=0.510). A propensity score-matched analysis of preterm births (n=4384) yielded a 138% increased relative risk of cerebral palsy associated with a motor vehicle crash (95% CI +27 to +349, p=0.007), equal to an absolute increase of about 10.9 additional cases per 1000 newborns (18.2 vs 7.3, p=0.010). CONCLUSIONS: Motor vehicle crashes during pregnancy may be associated with an increased risk of cerebral palsy among the subgroup of cases with preterm birth. The increase highlights a specific role for traffic safety advice in prenatal care. BMJ Publishing Group 2016-09-08 /pmc/articles/PMC5051428/ /pubmed/27650764 http://dx.doi.org/10.1136/bmjopen-2016-011972 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Obstetrics and Gynaecology
Redelmeier, Donald A
Naqib, Faisal
Thiruchelvam, Deva
R Barrett, Jon F
Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis
title Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis
title_full Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis
title_fullStr Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis
title_full_unstemmed Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis
title_short Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis
title_sort motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis
topic Obstetrics and Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051428/
https://www.ncbi.nlm.nih.gov/pubmed/27650764
http://dx.doi.org/10.1136/bmjopen-2016-011972
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