Abstract
Infection occurring during the prenatal, perinatal, and early postnatal periods of life can cause cerebral palsy (CP). Gestational age may be an associated risk factor, but both preterm and term infants can be affected. Injury to the brain causing CP can be the result of both direct and secondary pathogenesis from infectious etiologies. Direct infection of the central nervous system, damaging immune-mediated inflammatory response to maternal or congenital infection, or sequelae from infection such as hypoxic-ischemic events can all lead to insult to the brain. Pathogens causing these CP-related congenital infections can vary but are usually neurotropic viruses including cytomegalovirus (CMV). Maternal bacterial infections such as chorioamnionitis or urinary tract infection and neonatal bacterial infections such as sepsis and meningitis have been associated with CP and may correlate with specific subtypes of CP. Distinct clinical manifestations and stigmata can help identify these infections, in addition to diagnostics such as serology and molecular testing. However, treatments and therapies can be limited and toxic and may have little direct effect on the development of CP and its long-term outcomes.
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References
ACOG Committee on Practice Bulletins (2007) ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists. No. 82 2007. Management of herpes in pregnancy. Obstet Gynecol 109(6): 1489–1498
Ahlin K, Himmelmann K, Gudrun H et al (2013) Cerebral palsy and perinatal infection in children born at term. Obstet Gynecol 122:41–49. https://doi.org/10.1097/AOG.0b013e318297f37f
Ahlin K, Himmelmann K, Nilsson S et al (2016) Antecedents of cerebral palsy according to severity of motor impairment. Acta Obstet Gynecol Scand 95(7): 793–802. https://doi.org/10.1111/aogs.12885
American Academy of Pediatrics (AAP) (2015a) Cytomegalovirus infection. In: Kimberlin DW, Brady MT, Jackson MA, Long SS (eds) Red book 2015 report of the committee in infectious diseases, 30th edn. American Academy of Pediatrics, Elk Grove Village, pp 317–322
American Academy of Pediatrics (AAP) (2015b) Enterovirus (nonpoliovirus): (Group and B Coxsackieviruses, echoviruses, numbered enteroviruses). In: Kimberlin DW, Brady MT, Jackson MA, Long SS (eds) Red book 2015 report of the committee in infectious diseases, 30th edn. American Academy of Pediatrics, Elk Grove Village, p 336
American Academy of Pediatrics (AAP) (2015c) Herpes simplex. In: Kimberlin DW, Brady MT, Jackson MA, Long SS (eds) Red book 2015 report of the committee in infectious diseases, 30th edn. American Academy of Pediatrics, Elk Grove Village, pp 432–445
Bale JF Jr (2009) Fetal infections and brain development. Clin Perinatol 36(3):639–653. https://doi.org/10.1016/j.clp.2009.06.005
Bear JJ, Wu YW (2016) Maternal infections during pregnancy and cerebral palsy in the child. Pediatr Neurol 57:74–79. https://doi.org/10.1016/j.pediatrneurol.2015.12.018
Brown ZA, Wald A, Morrow RA et al (2003) Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant. JAMA 289(2):203–209
Corey L, Whitley RJ, Stone EF et al (1988) Difference between herpes simplex virus type 1 and type 2 neonatal encephalitis in neurological outcome. Lancet 1(8575–6):1–4
Dakovic I, da Graça AM, Folha T et al (2014) Clinical features of cerebral palsy in children with symptomatic congenital cytomegalovirus infection. Eur J Paediatr Neurol 5:618–623. https://doi.org/10.1016/j.ejpn.2014.04.007
Edwards MS, Baker JC (2018) Bacterial infections in the neonate. In: Long SS, Prober CG, Fischer M (eds) Principles and practice pediatric infectious diseases, 5th edn. Elsevier, Philadelphia, p 554
Engman ML, Adolfsson I, Lewensohn-Fuchs I et al (2008) Neuropsychologic outcomes in children with neonatal herpes encephalitis. Pediatr Neurol 38(6):398–405. https://doi.org/10.1016/j.pediatrneurol.2008.02.005
Gerardin P, Samperiz A, Ramful D et al (2014) Neurocognitive outcome of children exposed to perinatal mother-to-child chikungunya virus infection: the CHIMERE cohort study on Reunion Island. PLoS Negl Trop Dis 8(7):e2996. https://doi.org/10.1371/journal.pntd.0002996
Gibson CS, MacLennan AH, Goldwater PN et al (2006) Neurotropic viruses and cerebral palsy: population based case-control study. BMJ 332(7533):76–80. https://doi.org/10.1136/bmj.38668.616806.3A
Gilstrap LC, Ramin SM (2000) Infection and cerebral palsy. Semin Perinatol 24(3):200–203
Horvath B, Grasselly M, Bodecs T et al (2012) Histological chorioamnionitis is associated with cerebral palsy in preterm neonates. Eur J Obstet Gynecol Reprod Biol 163(2):160–164. https://doi.org/10.1016/j.ejogrb.2012.05.012
James SH, Kimberlin DW (2015a) Neonatal herpes simplex virus infection. Infect Dis Clin N Am 29(3): 391–400. https://doi.org/10.1016/j.idc.2015.05.001
James SH, Kimberlin DW (2015b) Neonatal herpes simplex virus infection: epidemiology and treatment. Clin Perinatol 42(1):47–59, viii. https://doi.org/10.1016/j.clp.2014.10.005
Jelin AC, Salmeen K, Gano D et al (2016) Perinatal neuroprotection update [version 1; referees: 2 approved]. F1000Research. https://doi.org/10.12688/f1000research.8546.1
Kimberlin DW, Whitley RJ, Wan W et al (2011) Oral acyclovir suppression and neurodevelopment after neonatal herpes. N Engl J Med 365(14):1284–1292. https://doi.org/10.1056/NEJMoa1003509
Kimberlin DW, Baley J, Committee on Infectious Diseases, Committee on Fetus and Newborn (2013) Guidance on management of asymptomatic neonates born to women with active genital herpes lesions. Pediatrics 131(2):383–386. https://doi.org/10.1542/peds.2012-3217
Langerak NG, Du Toi J, Burger M et al (2013) Spastic diplegia in children with HIV encephalopathy: first description of gait and physical status. Dev Med Child Neurol 56(7):686–694. https://doi.org/10.1111/dmcn.12319
MacLennan AH, Thompson SC, Gecz J (2015) Cerebral palsy: causes, pathways, and the role of genetic variants. Am J Obstet Gynecol 213(6):779–788. https://doi.org/10.1016/j.ajog.2015.05.034
McMichael G, MacLennan A, Gibson C et al (2012) Cytomegalovirus and Epstein-Barr virus may be associated with some cases of cerebral palsy. J Matern Fetal Neonatal Med 25(10):2078–2081. https://doi.org/10.3109/14767058.2012.666587
Messacar K, Modlin F, John, Abzug JM (2018) Enteroviruses and parechoviruses. In: Long SS, Prober CG, Fischer M (eds) Principles and practice pediatric infectious diseases, 5th edn. Elsevier, Philadelphia, pp 1205–1213
Miller JE, Pedersen LH, Streja E et al (2013) Maternal infections during pregnancy and cerebral palsy: a population-based cohort study. Paediatr Perinat Epidemiol 27(6):542–552. https://doi.org/10.1111/ppe.12082
Neufeld MD, Frigon C, Graham AS et al (2005) Maternal infection and risk of cerebral palsy in term and preterm infants. J Perinatol 25(2):108–113. https://doi.org/10.1038/sj.jp.7211219
Pass RF (2018) Cytomegalovirus. In: Long SS, Prober CG, Fischer M (eds) Principles and practice pediatric infectious diseases, 5th edn. Elsevier, Philadelphia, pp 1073–1080
Pharoah PO, Cooke T, Rosenbloom L (1989) Acquired cerebral palsy. Arch Dis Child 64(7):1013–1016
Ramos R, Viana R, Brainer-Lima A et al (2017) Perinatal chikungunya virus-associated encephalitis leading to postnatal-onset microcephaly and optic atrophy. Pediatr Infect Dis J. https://doi.org/10.1097/INF.0000000000001690
Schuler-Faccini L, Ribeiro EM, Feitosa IM et al (2016) Possible association between Zika virus infection and microcephaly – Brazil, 2015. MMWR Morb Mortal Wkly Rep 65(3):59–62. https://doi.org/10.15585/mmwr.mm6503e2
Shatrov JG, Birch SC, Lam LT et al (2010) Chorioamnionitis and cerebral palsy: a meta-analysis. Obstet Gynecol 116(2 Pt 1):387–392. https://doi.org/10.1097/AOG.0b013e3181e90046
Shevell A, Wintermark P, Benini R et al (2014) Chorioamnionitis and cerebral palsy: lessons from a patient registry. Eur J Paediatr Neurol 18(3):301–307. https://doi.org/10.1016/j.ejpn.2013.12.005
Smithers-Sheedy H, Raynes-Greenow C, Badawi N et al (2017) Congenital cytomegalovirus among children with cerebral palsy. J Pediatr 181:267–271. https://doi.org/10.1016/j.jpeds.2016.10.024
Staples JE, Powers M (2018) Togaviridae: alphaviruses. In: Long SS, Prober CG, Fischer M (eds) Principles and practice pediatric infectious diseases, 5th edn. Elsevier, Philadelphia, p 1126
Verboon-Maciolek MA, Groenendaal F, Hahn CD et al (2008) Human parechovirus causes encephalitis with white matter injury in neonates. Ann Neurol 64(3): 266–273. https://doi.org/10.1002/ana.21445
Wheater M, Rennie JM (2000) Perinatal infection is an important risk factor for cerebral palsy in very-low-birthweight infants. Dev Med Child Neurol 42(6): 364–367
Wu Y, Colford JM (2000) Chorioamnionitis as a risk factor for cerebral palsy: a meta-analysis. JAMA 284(11): 1417–1424
Wu YW, Escobar GJ, Grether JK et al (2003) Chorioamnionitis and cerebral palsy in term and near-term infants. JAMA 290(20):2677–2684. https://doi.org/10.1001/jama.290.20.2677
Wu T, Fan XP, Wang WY et al (2014) Enterovirus infections are associated with white matter damage in neonates. J Paediatr Child Health 50(10):817–822. https://doi.org/10.1111/jpc.12656
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Rellosa, N. (2018). Infectious Etiologies of Cerebral Palsy. In: Miller, F., Bachrach, S., Lennon, N., O'Neil, M. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-319-50592-3_3-1
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DOI: https://doi.org/10.1007/978-3-319-50592-3_3-1
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