Background and aim:

The association between maternal infection during pregnancy and the risk of cerebral palsy has been previously reported. However, their results were relatively inconsistent. This systematic review and meta-analysis were carried out to investigate the association between maternal infection during pregnancy and the risk of cerebral palsy in children.

Methods:

PubMed, Scopus, and Web of Sciences databases were searched from inception to October 28, 2019. Heterogeneity was assessed using the I² value. In case of substantial heterogeneity (I² > 50%), a random effects model was applied, otherwise, a fixed effects model was used. The pooled associations were expressed as relative risks (RRs) and 95% confidence intervals (CIs). Publication bias and quality of studies included in the systematic review were checked using the Egger’s regression test and Newcastle-Ottawa Scale (NOS), respectively.

Results:

Thirty-seven studies were included in the systematic review. Among them, 21 studies were eligible for the meta-analysis. The pooled RR of cerebral palsy risk was 2.50 (95% CI 1.94, 3.21; I² = 88.7%, P < .001) among children born to mothers who had any infection during pregnancy. The risk was increased to 2.85 (95% CI 1.96, 4.15; I² = 75.9%, P < .001) when the mother was diagnosed with chorioamnionitis. Publication bias tests suggested no evidence of potential publication bias and 76% of the studies included in the meta-analysis were of high quality (NOS ≥ 6).

Conclusion:

This systematic review and meta-analysis provides evidence that maternal infection during pregnancy may be associated with an increased risk of cerebral palsy in children.

中文翻译：

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孕期母体感染和儿童脑瘫风险：系统评价和 Meta 分析

背景和目标：

先前曾报道过怀孕期间母体感染与脑瘫风险之间的关联。然而，他们的结果相对不一致。本系统评价和荟萃分析旨在调查孕期母体感染与儿童脑瘫风险之间的关联。

方法：

从开始到 2019 年 10 月 28 日检索了 PubMed、Scopus 和 Web of Sciences 数据库。使用 I ²值评估异质性。如果存在较大异质性（I ² > 50%），则采用随机效应模型，否则采用固定效应模型。汇总的关联表示为相对风险 (RR) 和 95% 置信区间 (CI)。系统评价中包括的发表偏倚和研究质量分别使用 Egger 回归检验和纽卡斯尔-渥太华量表 (NOS) 进行检查。

结果：

三十七项研究被纳入系统评价。其中，21项研究符合荟萃分析的条件。在怀孕期间有任何感染的母亲所生的孩子中，脑瘫风险的汇总 RR 为 2.50（95% CI 1.94，3.21；I ² = 88.7%，P < .001）。当母亲被诊断患有绒毛膜羊膜炎时，风险增加到 2.85（95% CI 1.96，4.15；I ² = 75.9%，P < .001）。发表偏倚测试表明没有潜在发表偏倚的证据，荟萃分析中 76% 的研究是高质量的（NOS ≥ 6）。

结论：

这项系统评价和荟萃分析提供的证据表明，孕期母体感染可能与儿童脑瘫风险增加有关。