Pregnancy Outcomes Among Individuals With Cerebral Palsy: A Population-Based Cohort Study
Prepared by: AACPDM Digest reviewer/Nelleke G. Langerak, PT, PhD
Keywords:
- Cerebral palsy
- Epidemiologic studies
- Pregnancy outcomes
Study Type: Population-based cohort study
Summary:
Despite increasing pregnancy rates among people with physical disabilities, research on pregnancy outcomes among individuals with cerebral palsy (CP) remains limited. The purpose of this study was to compare maternal, neonatal and non-obstetrical medical complications among pregnant individuals with and without CP using population-based health administrative data from Ontario, Canada.
Individuals aged 13–54 years with a livebirth or stillbirth (>20 weeks’ gestation) between 2004 and 2023 were included. Outcomes among 1,400 individuals with CP were compared with those of 2,276,561 individuals without CP. Modified Poisson regression analyses, adjusted for sociodemographic and clinical factors, were used to estimate relative risks and 95% confidence intervals for maternal, neonatal, and non-obstetrical medical complications.
This study showed that individuals with CP had an increased risk of severe maternal morbidity or mortality, caesarean section and maternal hospital readmission compared with individuals without CP. Their newborns were at increased risk of preterm birth, small for gestational age, congenital anomalies, and severe neonatal morbidity or mortality. Individuals with CP were also at increased risk of seizure disorders and urinary tract infections during the perinatal period. Risks were highest among individuals with more severe CP, based on subgroup analyses.
These population-level trends suggest the need for improved preconception counselling, enhanced perinatal monitoring and comprehensive postpartum support for individuals with CP. This highlights the importance of coordinated, multidisciplinary care involving obstetric, neurological and rehabilitation specialists to provide individualized support to optimize pregnancy, delivery, and postpartum outcomes.