Does getting injured during pregnancy impact a baby’s risk for cerebral palsy?
A new study from ICES and McGill University finds that children of mothers who experienced unintentional injuries during pregnancy were at an increased risk for cerebral palsy, especially when the injury was more severe or resulted in delivery shortly after the injury.
Prior research has demonstrated that mothers who are injured during pregnancy, such as a car accidents or fall, can face health complications. However, there is limited knowledge on whether a mother’s injury would negatively impact the neurodevelopment of a child.
The study, published in JAMA Pediatrics, assessed whether mothers’ exposure to unintentional injury during pregnancy is associated with an increased risk of cerebral palsy (CP) in children in a cohort of approximately 2 million births in Ontario, Canada between 2002-2017.
“Accidents that result in injury are a fairly common occurrence during pregnancy,” says lead author Dr. Asma Ahmed, a former PhD student at McGill University, in the Department of Epidemiology, Biostatistics and Occupational Health and current postdoctoral research fellow in child health evaluative sciences at The Hospital for Sick Children (SickKids). “Our study found that unintentional injuries were more common in young mothers, those with substance use disorder, and those living in rural areas or neighbourhoods with fewer resources.”
The researchers also found that:
- Children exposed to maternal injury had a modest increase in the risk of CP, compared to those who were not exposed, after adjusting for factors such as the mother’s age, previous births, prenatal care, eligibility for provincial drug benefits, and neighbourhood-based socioeconomic characteristics.
- Severe injuries that resulted in hospitalization and the delivery of the baby within a week from the injury were associated with higher risks of CP.
- Approximately 8 per cent of women experienced more than one injury during pregnancy.
Motor vehicle-related accidents were associated with an increased risk of CP after adjusting for factors commonly associated with vehicle accidents (for example, younger age or low socioeconomic status). The researchers note this could be because injuries related to motor-vehicle accidents can be more severe and may result in greater adverse outcomes for the baby.
“We need to better support for babies whose mothers have been injured in pregnancy, especially after severe injuries,” says Dr. Ahmed. “As well, these findings suggest the need for early monitoring of babies’ development, regular check-ups and longer-term neurodevelopmental assessments.”
The study, “In-utero exposure to maternal injury and the risk of cerebral palsy” was published in JAMA Pediatrics.
Author block: Ahmed A, Rosella L, Oskoui M, Watson T, Yang S.
ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario
About McGill University
Founded in Montreal, Quebec, in 1821, McGill University is Canada’s top ranked medical doctoral university. McGill is consistently ranked as one of the top universities, both nationally and internationally. It is a world-renowned institution of higher learning with research activities spanning three campuses, 11 faculties, 13 professional schools, 300 programs of study and over 39,000 students, including more than 10,400 graduate students. McGill attracts students from over 150 countries around the world, its 12,000 international students making up 30% of the student body. Over half of McGill students claim a first language other than English, including approximately 20% of our students who say French is their mother tongue.
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is a founding member of Kids Health Alliance, a network of partners working to create a high quality, consistent and coordinated approach to paediatric health care that is centred around children, youth and their families. SickKids is proud of its vision for “Healthier Children. A Better World.”
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