Maternal hypertension and intrapartum fever are associated with increased risk of ischemic stroke during infancy

Abstract

Aim To examine maternal hypertension, diabetes, and intrapartum fever as potential risk factors for ischemic stroke in infants. Method We conducted a retrospective cohort study of 226117 children born from January 2000 to December 2007 who were enrolled in the South Carolina Medicaid program. We linked maternal and child Medicaid billing records and birth certificate data. Children with ischemic stroke were identified based on the International Classification of Diseases, Ninth Revision (ICD-9), code 434 in the child's billing data. Independent variables and covariates were identified using ICD-9 codes and birth certificate data. We modeled the odds of ischemic stroke diagnosis in infants, either before 30days of life or before 365days. Results Forty-three children were diagnosed with ischemic stroke before 30days and 161 before 365days. Maternal hypertension (odds ratio 2.31 before 30d) and intrapartum fever (odds ratio 3.36 <30d) were significantly associated with odds of ischemic stroke before 30days and before 365days; maternal diabetes was not. Interpretation Maternal hypertension and intrapartum fever appear to be risk factors for ischemic stroke in infants. Additional research is needed to determine the mechanism(s) underlying these associations and to develop effective preventive methods for high-risk infants. This article is commented on by Grunt and Steinlin on pages 8-9 of this issue. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.