223 Pregnancy outcomes of women with cerebral palsy: an international observational study

Abstract

Our current knowledge about reproductive health and pregnancy in women with Cerebral Palsy (CP) is limited. The lack of rigorous studies in this area may shape discussions with physicians about pre-pregnancy counseling, antepartum and postpartum management, attitudes, and care received. The goal of this study was to examine the reproductive health and pregnancy outcomes of women with CP. This is part of an international observational questionnaire examining pregnancy outcomes of women with CP. Multiple recruitment techniques were employed including partnering with cerebral palsy and disability organizations to distribute information regarding the study, as well as snowball and peer recruitment. A total of 158 participants from 15 countries participated in this study. Most participants (93/140, 66.4%) reported having spastic CP, 27/140 (19.3%) ataxia CP, 15/140 (10.7%) dyskinesia CP and 19/140 (13.6%) mixed CP. 50 births were included in this analysis. 16/50 (32.0%) reported anemia and 10/50 (20.0%) reported hyperemesis. 30/50 participants delivered vaginally (60.0%) and 18/50 delivered via caesarean section (36.0%). Preterm birth <37 weeks occurred in 20.0% of pregnancies (10/50). 8/50 (16.0%) developed preeclampsia, 6/50 (12.0%) developed gestational hypertension and 7/50 (14.0%) developed gestational diabetes. 5/50 (10.0%) of participants were admitted to a high-risk pregnancy unit. 15/50 (30.0%) participants reported experiencing postpartum depression. Women with cerebral palsy appear to be at increased risk of hyperemesis, anemia, preterm birth, gestational diabetes, hypertensive disorders of pregnancy, and admission to high risk pregnancy units during pregnancy. Following pregnancy, women with CP report high rates of postpartum depression. This information may assist in preconception counselling, pregnancy, and postpartum management. Further evaluation regarding identification of risk factors, such as pre-pregnancy health status may aid in better understanding of the etiology of these risks.