Background Cerebral Palsy (CP) is the most common childhood-onset physical disability in the United States. We investigated the association between maternal participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and CP risk in the offspring. Methods We analyzed California statewide birth records of 2,090,427 live births (2007–2015) from 1,673,395 women insured by Medi-Cal (Medicaid). CP was ascertained using diagnostic records from the Department of Developmental Services (up to 2021). We used generalized linear models to estimate the relative risk (RR) and 95% confidence interval (CI) for CP according to maternal WIC participation during pregnancy. We estimated the mediating roles of preterm birth and low birth weight. Results We observed a 16% lower risk of CP (RR = 0.84, 95% CI: 0.75, 0.95) associated with maternal WIC participation. The estimated association was stronger among mothers with less than a high school education (RR = 0.67, 95% CI: 0.55, 0.82). Preterm birth or low birth weight was estimated to mediate approximately 12–53% of the association between WIC participation and offspring CP risk. Conclusion In this California cohort of Medi-Cal-insured mothers, maternal participation in WIC was associated with a lower CP risk in the offspring. Impact statement <UnorderedList Mark="Bullet"> <ItemContent> Analysis of over two million live births insured by Medi-Cal showed that maternal participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during pregnancy is associated with a lower risk for cerebral palsy (CP) in the offspring. </ItemContent> <ItemContent> The observed protective associations were stronger among women with lower educational attainment and among the Hispanic subgroup in California. </ItemContent> <ItemContent> Preterm birth and low birth weight were estimated to explain part of the associations between WIC and CP. </ItemContent> <ItemContent> Our findings prompt further research into the role of maternal nutrition and health-seeking behaviors in the etiology of CP, especially among the socioeconomically disadvantaged population. </ItemContent> </UnorderedList>

The special supplemental nutrition program and risk of cerebral palsy

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2026年7月14日

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Yunyue Shi,
Haoran Zhuo,
Giselle Bellia,
Eugenia Y. Chock,
Zeyan Liew

摘要

Background

Cerebral Palsy (CP) is the most common childhood-onset physical disability in the United States. We investigated the association between maternal participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and CP risk in the offspring.

Methods

We analyzed California statewide birth records of 2,090,427 live births (2007–2015) from 1,673,395 women insured by Medi-Cal (Medicaid). CP was ascertained using diagnostic records from the Department of Developmental Services (up to 2021). We used generalized linear models to estimate the relative risk (RR) and 95% confidence interval (CI) for CP according to maternal WIC participation during pregnancy. We estimated the mediating roles of preterm birth and low birth weight.

Results

We observed a 16% lower risk of CP (RR = 0.84, 95% CI: 0.75, 0.95) associated with maternal WIC participation. The estimated association was stronger among mothers with less than a high school education (RR = 0.67, 95% CI: 0.55, 0.82). Preterm birth or low birth weight was estimated to mediate approximately 12–53% of the association between WIC participation and offspring CP risk.

Conclusion

In this California cohort of Medi-Cal-insured mothers, maternal participation in WIC was associated with a lower CP risk in the offspring.

Impact statement

Analysis of over two million live births insured by Medi-Cal showed that maternal participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during pregnancy is associated with a lower risk for cerebral palsy (CP) in the offspring.

The observed protective associations were stronger among women with lower educational attainment and among the Hispanic subgroup in California.

Preterm birth and low birth weight were estimated to explain part of the associations between WIC and CP.

Our findings prompt further research into the role of maternal nutrition and health-seeking behaviors in the etiology of CP, especially among the socioeconomically disadvantaged population.