1. bookVolume 84 (2021): Issue 2 (June 2021)
Journal Details
First Published
24 Jan 2008
Publication timeframe
4 times per year
access type Open Access

Maternal age as a risk factor for cerebral palsy

Published Online: 01 Jul 2021
Page range: 117 - 131
Received: 24 Oct 2020
Accepted: 28 Apr 2021
Journal Details
First Published
24 Jan 2008
Publication timeframe
4 times per year

The relationship between maternal age and the occurrence of cerebral palsy is still highly controversial. The aim of the study was to examine the effect of maternal age on the risk of CP development, taking into account all significant risk factors and the division into single, twin, full-term, and pre-term pregnancies.

The survey covered 278 children with CP attending selected educational institutions in Poland. The control group consisted of data collected from the medical records of 435 children born at Limanowa county hospital, Poland. The analyses included socio-economic factors, factors related to pregnancy and childbirth, and factors related to the presence of comorbidities and diseases in the child. Constructed logistic regression models were used for statistical analyses.

For all age categories included in the estimated models (assessing the effect of demographic factors on the development of CP), only the category of ≤24 years of age (in the group of all children) was significant. It was estimated that in this mother’s age category, the risk of CP is lower (OR 0.6, 95% CI: 0.3–1.0) in comparison to mothers aged 25-29 (p = 0.03). However, estimation with the use of a complex logistic regression model did not show any significant effect of maternal age on the incidence of CP in groups from different pregnancies types.

It became apparent that maternal age is a weak predictor of CP, insignificant in the final logistic regression model. It seems correct to assume that the studies conducted so far, showing a significant effect of maternal age in this respect, may be associated with bias in the estimators used to assess the risk of CP due to the fact that other important risk factors for CP development were not included in the research.


Albers LL, Lydon-Rochelle MT, Krulewitch CJ. 1995. Maternal Age And Labor Complications In Healthy Primigravidas At Term. Journal of Nurse-Midwifery 40(1):4–12. Search in Google Scholar

Asher P, Schonell E. 1950. A survey of 400 cases of cerebral palsy in childhood. Arch Dis Child. 25(124):360–79. Search in Google Scholar

Baxter P. 209. Preventing cerebral palsy: hidden improvements. Dev Med Child Neurol 51(3):335. Search in Google Scholar

Blair E, Stanley F. 2002. Causal pathways to cerebral palsy. Curr Paediatr 12(3):179–85. Search in Google Scholar

Blair E, Watson L. 2006. Epidemiology of cerebral palsy. Seminars in Fetal and Neonatal Medicine 11:117–25. Search in Google Scholar

Bober T, Kobel-Buys K. 2006. Mózgowe porażenie dziecięce z doświadczeń trzyletniego programu rehabilitacyjnego. Wydawnictwo AWF Wrocław. Search in Google Scholar

Canterino JC.2012. Advanced maternal age and risks for adverse outcomes. The Female Patient 37:25–33. Search in Google Scholar

Chitra S, Nandini M. 2005. Cerebral palsy-definition, classification, etiology and early diagnosis. Indian J Pediatr 72(10):865–8. Search in Google Scholar

Cieślik K, Waszak M. 1992. Próba określenia wpływu czynnika wieku matki na rozwój cech somatycznych płodu. Przegląd Antropologiczny 55:57–62. Search in Google Scholar

Colver AF, Gibson M, Hey EN, Jarvis SN, Mackie PG, Richmond S. 2000. Increasing rates of cerebral palsy across the severity spectrum in north-east England 1964–1993. Arch Dis Child Fetal Neonatal Ed 83:7–12. Search in Google Scholar

Fletcher NA., Foley J. 1993. Parental age, mutation, and cerebral palsy. J Med Genet 30(1):44–6. Search in Google Scholar

Gilbert WM, Jacoby BN, Xing G, Danielsen BD, Smith LH. 2010. Adverse Obstetrical Events are Associated with Significant Risk of Cerebral Palsy. Am J Obstet Gynecol 203(4):1–5 Search in Google Scholar

Gray PH, Jones P, O’Callaghan JM. 2001. Maternal antecedents for cerebral palsy in extremely preterm babies: a case control study. Dev Med Child Neurol 43:580–5. Search in Google Scholar

Grether J, Nelson KB, Walsh E, Willoughby RE, Redline RW. Intrauterine Exposure to Infection and Risk of Cerebral Palsy in Very Preterm Infants. Arch Pediatr Adolesc Med. 157:26–32. Search in Google Scholar

Heffner LJ. 2004. Advanced maternal age-how old is too old? N Engl J Med 351(19):1927–9. Search in Google Scholar

Himmelmann K, Hagberg G, Uvebrant P. 2010. The changing panorama of cerebral palsy in Sweden. X. Prevalence and origin in the birth-year period 1999–2002. Acta Paediatrica 99:1337–43. Search in Google Scholar

Hoque ME. 2012. Advanced maternal age and outcomes of pregnancy: A retrospective study from South Africa. Biomedical Research 23(2):281–5. Search in Google Scholar

Jacobsson B, Hagberg G, Hagberg B, Ladfors L, Niklasson A, Hagberg H. 2002. Cerebral palsy in preterm infants: a population-based case-control study of antenatal and intrapartal risk factors. Acta Paediat-rica 91:846–951. Search in Google Scholar

Jacobsson B, Hagberg G. 2004. Antenatal risk factors for cerebral palsy. Best Pract Res Clin Obstet Gynaecol 18(3):425–36. Search in Google Scholar

Jacobsson B, Ladfors L, Milson I. 2004. Advanced Maternal Age and Adverse Perinatal Outcome. Am Coll Obsteric Gynecol 104(4):727–32. Search in Google Scholar

Johnson A, Catterson J. 1988. Trends in birth prevalence of cerebral palsy. Arch Dis Child 63(3):340. Search in Google Scholar

Johnson JA, Tough S, Wilson RD, Audibert F, Blight C, Brock JA, Cartier L, Désilets V, Gagnon A, Langlois S, Murphy-Kaulbeck L, Okun N. 2012. Delayed Child-Bearing. J Obstet Gynaecol Can 34(1):80–93. Search in Google Scholar

Jóźwiak M. 2001. Mózgowe porażenie dziecięce-postęp w diagnostyce i terapii. Ortopedia Traumatologia Rehabilitacja 3(4):445–9. Search in Google Scholar

Jóźwiak S. 2001. Neurologiczne podstawy deficytów ruchowych w mózgowym porażeniu dziecięcym. Ortopedia Traumatologia Rehabilitacja 3(4):472–5. Search in Google Scholar

Karoshi M, Newbold S, B-Lynch Ch, Keith LG. 2012. Preconceptional Medicine and Management. Wielka Brytania Wydawnictwo Sapiens, pp. 3–17. Search in Google Scholar

Khalil A, Syngelaki A, Maiz N, Zinevich Y, Nicolaides KH. 2013. Maternal age and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol 42:634–43. Search in Google Scholar

Kiely J, Paneth N, Stein Z, Susser M. 1981. Cerebral palsy and newborn care. I: Secular trends in cerebral palsy. Dev Med Child Neurol 23:533–8. Search in Google Scholar

Koman AL, Smith PB, Shilt JS. 2004. Cerebral palsy. The Lancet 363:1619–31. Search in Google Scholar

Korzeniewski S. 2006. The descriptive epidemiology of cerebral palsy. Clinics in Perinatology 33:251–67. Search in Google Scholar

Kuban K, Allred E, O’Shea M, Paneth N, Pagano M, Leviton A. 2008. An algorithm for identifying and classifying cerebral palsy in young children. J Pediat 153(4):466–72. Search in Google Scholar

Kułak W, Sobaniec W. 2004. Cerebral palsy in children in north-eastern Poland. Journal of Pediatric Neurology 2(2):79–84. Search in Google Scholar

Kwolek A, Majka M, Pabis M. 2001. Rehabilitacja dzieci z porażeniem mózgowym – problemy, aktualne kierunki. Ortop Traumatol Rehab 3(4):499–507. Search in Google Scholar

Lang TC, Fuentes-Afflick E, Gilbert WM, Newman T, Xing G, Wu YW. 2012. Cerebral Palsy Among Asian Ethnic Subgroups. Pediatrics 129(4):992–8. Search in Google Scholar

Laopaiboon M, Lumbiganon P, Intarut N, Mori R, Ganchimeg T, Vogel JP, Souza JP, Gülmezoglu AM. 2014. Advanced maternal age and pregnancy outcomes: a multi-country assessment. BJOG 121:49–56. Search in Google Scholar

Lin JP. 2003. The cerebral palsies: a physiological approach. J Neurol Neurosurg Psychiatry 74:23–9. Search in Google Scholar

Liu K, Case A. 2011. Advanced Reproductive Age and Fertility. J Obstet Gynaecol Can 269:1165–73. Search in Google Scholar

McIntyre S, Taitz D, Keogh J, Goldsmith S, Badawi N, Blair E. 2013. A systematic review of risk factors for cerebral palsy in children born at term in developed countries. Dev Med Child Neurol 55:499–508. Search in Google Scholar

Michałowicz R. 2001. Mózgowe porażenie dziecięce. Warszawa: Wydawnictwo Lekarskie PZWL. Search in Google Scholar

Michalska A, Boksa E, Wendorff J, Wiktor PJ. 2012. Jakość życia dzieci i młodzieży z mózgowym porażeniem dziecięcym i niepełnosprawnością intelektualną. Wybrane uwarunkowania społeczno-demograficzne. Neurologia Dziecięca 21(42): 35–44. Search in Google Scholar

Milewska A, Mileańczuk-Lubecka BA, Koch-anowski J, Werner B. 2011. Analiza czynników ryzyka mózgowego porażenia dziecięcego. Nowa Pediatria 4:79–84. Search in Google Scholar

Murphy DJ, Sellers S, MacKenzie IZ, Yudkin PL. Johnson AM. 1995. Case-control study of antenatal and intrapartum risk factors for cerebral palsy in very preterm singleton babies. The Lancet 346 (8988):1449–54. Search in Google Scholar

O’Shea M, Klinepeter KL, Dillard R. 1998. Prenatal events and the risk of cerebral palsy in very low birth weight infants. Am J Epidemiol 147(4):362–9. Search in Google Scholar

Öztürk A, Demirici F, Yavuz T, Yildiz S, Degirmenci Y, Döşoglu M, Avşar Y. 2007. Ante-natal and delivery risk factors and prevalence of cerebral palsy in Duzce (Turkey). Brain Dev 29(1):39–42. Search in Google Scholar

Platt MJ, Pharoah POD. 1995. Epidemiology of cerebral palsy. Curr Paediatr 5:151–5. Search in Google Scholar

Radecka G, Chmielińska U. 1974. Analiza przyczyn mózgowego porażenia dziecięcego. Neurologia i Neurochirurgia Polska 8 (1):7–11. Search in Google Scholar

Rajaee M, Amirzadeh S, Mirblook F, Soltani MA. 2010. The Effect of Maternal Age on Pregnancy Outcome. Asian J Med Sci 2(3):159–62. Search in Google Scholar

Reid S, Carlin J, Reddihough D. 2011. Rates of cerebral palsy in Victoria, Australia, 1970 to 2004:has there been a change? Dev Med Child Neurol 53:907–12. Search in Google Scholar

Robertson ChMT, Watt M, Yasui Y. 2007. Changes in the prevalence of cerebral palsy for children born very prematurely within a population-based program over 30 years. JAMA-J Am Med Assoc 297(24):2733–40. Search in Google Scholar

Rosenbaum P, Paneth N, Leviton A., Goldstein M, Bax M. 2007. A report: the definition and classification of cerebral palsy. Dev Med Child Neurol 109:8–14. Search in Google Scholar

Schaefer GB. 2008. Genetics Considerations in Cerebral Palsy. Seminars in Pediatrics Neurology 15:21–6. Search in Google Scholar

Sellier E, Anderson G, Surman G, Cans Ch. 2010. Trends in prevalence of cerebral palsy in children born with a birthweight of 2500 g or over in Europe from 1980–1998. Eur J Epidemiol 25(9):635–42. Search in Google Scholar

Škrablin S, Maurac I, Banovič V, Bošnjak-Nadj K. 2008. Perinatal factors associated with the neurologic impairment of children born preterm. Int J Gynaecol Obstet 102:12–8. Search in Google Scholar

Soleimani F, Vameghi R, Biglarian A. 2013. antenatal and intrapartum risk factors of cerebral palsy in term and near-term newborns. Arch Iran Med 16(4):213–6. Search in Google Scholar

Spinillo A, Capuzzo E, Cavallini A, Stronati M, De Santolo A, Fazzi E. 1998. Preeclampsia, preterm delivery and infant cerebral palsy. Eur J Obstet Gynecol 77:151–5. Search in Google Scholar

Sternal M, Kwiatkowska B, Borysławski K. 2011. Czynniki zwiększające ryzyko mózgowego porażenia dziecięcego. Pediatria Polska 86(2):163–8. Search in Google Scholar

Sternal M, Kwiatkowska B, Borysławski K, Tomaszewska A. 2020a. Paternal age and the risk of cerebral palsy. Anthropological Review 83(1):31–41. doi:10.2478/anre-2020-0002. Search in Google Scholar

Sternal M, Kwiatkowska B, Borysławski K, Tomaszewska A. 2020b. The effect of increased bilirubin level on the risk of cerebral palsy. Anthropological Review 83(2):185–95. doi:10.2478/anre-2020-0013. Search in Google Scholar

Sternal M, Kwiatkowska B, Borysławski K, Tomaszewska A. 2021. The influence of neonatal infections on the development of cerebral palsy. Anthropological Review 84(1): 37–49. doi:10.2478/anre-2021-0007. Search in Google Scholar

Takahashi R, Yamada M, Takahashi T, Ito T, Nakae S, Kobayashi Y, Onuma A. 2005. Risk factors for cerebral palsy in preterm infants. Early Hum Dev 81:545–53. Search in Google Scholar

Thorngren-Jerneck K, Herbst A. 2006. Perinatal Factors Associated with Cerebral Palsy in Children Born in Sweden. Obstet Gynecol 108(6):1499–505. Search in Google Scholar

Usta IM, Nassar AH. 2008. Advanced Maternal Age. Part I: Obstetric Complications. Am J Perinatol 25:521–34. Search in Google Scholar

Wu YW, Croen L, Shah S, Newman T, Najjar D. 2010. Cerebral palsy in a term population: risk factors and neuroimaging finding. Pediatrics 118(2):690–7. Search in Google Scholar

Wu YW, Xing G, Afflick E, Danielson B, Smith L, Gilbert W. 2011. Racial, ethnic and socioeconomic disparities in the prevalence of cerebral palsy. Pediatrics 127(3):672–81. Search in Google Scholar

Wu YW, Colford JM. 2000. Chorioamnionitis as a risk factor for cerebral palsy. JAMA 284(11):1417–24. Search in Google Scholar

Zgorzalewicz B, Mieszczanek T, Zgorzalewicz M. 2001. Epidemiologia opisowa mózgowego porażenia dziecięcego. Ortop Traumatol Rehab 3(4):467–71. Search in Google Scholar

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