Abstract
Background
The birth of a child affected by a threatened abortion (TAB) in utero is associated with autism spectrum disorder; association with other neurological disorders is unknown.
Methods
This nationwide registry-based cohort study included singletons live-born in Denmark (1979–2010), followed through 2016. The outcomes were epilepsy, cerebral palsy (CP) and attention-deficit/hyperactivity disorder (ADHD). We used Cox regression to compute hazard ratios (HRs), adjusted for birth year, birth order, parental age, morbidity, medication use and maternal socio-economic factors. To remove time-invariant family-shared confounding, we applied sibling analyses.
Results
The study population included 1 864 221 singletons live-born in 1979–2010. Among the TAB-affected children (N = 59 134) vs TAB-unaffected children, at the end of follow-up, the cumulative incidence was 2.2% vs 1.6% for epilepsy, 0.4% vs 0.2% for CP and 5.5% vs 4.2% for ADHD (for children born in 1995–2010). The adjusted HRs were 1.25 [95% confidence interval (CI) 1.16–1.34] for epilepsy, 1.42 (95% CI 1.20–1.68) for CP and 1.21 (95% CI 1.14–1.29) for ADHD. In the sibling design, the adjusted HRs were unity for epilepsy (full siblings: 0.96, 95% CI 0.82–1.12; maternal: 1.04, 95% CI 0.90–1.20; paternal: 1.08, 95% CI 0.93–1.25) and ADHD (full: 1.08, 95% CI 0.92–1.27; maternal: 1.04, 95% CI 0.90–1.20; paternal: 1.08, 95% CI 0.93–1.25). For CP, HRs shifted away from unity among sibling pairs (full: 2.92, 95% CI 1.33–6.39; maternal: 2.03, 95% CI 1.15–3.57; paternal: 3.28, 95% CI 1.36–7.91).
Conclusions
The birth of a child affected by TAB in utero was associated with a greater risk of CP, but not epilepsy or ADHD.
Balancing for gross motor ability differences in exercise videogames between youth with cerebral palsy at Gross Motor Function Classification System levels II and III
