Pregnancy Outcomes Among Individuals With Cerebral Palsy: A Population-Based Cohort Study

Area of Science:

• Obstetrics and Gynecology
• Neurology
• Public Health

Background:

• Cerebral palsy (CP) is a group of permanent movement disorders that can cause activity limitations.
• Pregnancy in individuals with CP may present unique medical challenges and risks.
• Understanding these risks is essential for optimizing maternal and neonatal outcomes.

Purpose of the Study:

• To compare the risks of maternal, neonatal, and non-obstetrical medical complications in individuals with CP versus those without CP.
• To identify specific adverse pregnancy outcomes associated with cerebral palsy.

Main Methods:

• A population-based cohort study was conducted in Ontario, Canada, from 2004 to 2023.
• Included females aged 13-54 years with a livebirth or stillbirth.
• Compared 1400 individuals with CP to 2,276,561 individuals without CP using modified Poisson regression, adjusting for socio-demographics and clinical characteristics.

Main Results:

• Individuals with CP had significantly higher risks of severe maternal morbidity or mortality (aRR 1.79), caesarean section (aRR 1.38), and maternal hospital readmission (aRR 1.86).
• Newborns of individuals with CP faced increased risks of preterm birth (aRR 1.67), small for gestational age (aRR 1.34), congenital anomalies (aRR 1.77), and severe neonatal morbidity or mortality (aRR 1.48).
• Elevated risks for seizure disorders (aRR 13.06) and urinary tract infections (aRR 1.50) were also observed perinatally in individuals with CP.

Conclusions:

• Individuals with cerebral palsy experience a significantly elevated risk of adverse pregnancy outcomes.
• Findings underscore the necessity for enhanced preconception counseling, meticulous perinatal monitoring, and robust postpartum support.
• Multidisciplinary care teams are vital for facilitating comprehensive care for pregnant individuals with CP.