This study is performed at the Division of Occupational and Environmental Medicine, Lund University, Sweden in collaboration with Department of Occupational and Environmental Medicine, Bispebjerg and Fredriksberg Hospital, Denmark.

Background
Cerebral palsy (CP) refers to a wide range of different motor impairments due to congenital malformation, injury based or other permanent function abnormality in the brain. The majority of all cerebral palsy occurs during fetal life but can also occur during delivery however, it can take up to four years before the child is diagnosed. The aetiology of CP is unclear although some risk factors have been identified and recently fetal exposure to fluorinated compounds was suggested to be associated with CP. Since these compounds are common in our everyday life, such as water repellents in clothing, more research was needed.

Aim of the studies
We had the possibility to conduct large epidemiological studies using register data and biobank data. We have conducted two separate studies where the overall aim was to understand more about the aetiology of CP.

Results
In the first study we used a national disease register (CPUP) that includes all children diagnosed with CP since 1994 and a Swedish regional medical birth register. We studied the association between both perinatal and antenatal risk factors and CP stratified by birth weight and we found that still, most of the underlying risk factors for CP is unknown (submitted manuscript).

In the second study the aim was specifically to study the association between fluorinated compounds and CP. We used data from a large biobank in Skåne that includes more than 250,000 serum samples from all early pregnancies since 1990 and onwards. Again, cases were retrieved from the disease register CPUP (n=340), controls were collected from the regional medical birth register (n=342).  Based on general health information from the Medical Birth Registry the link between maternal exposure to various hormone disrupting compounds and the occurrence of CP was studied. The preliminary result does not support an association between level of fluorinated compounds during pregnancy and CP (manuscript).

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