Cerebral palsy is caused by abnormal brain development or brain damage in developing babies, typically during pregnancy or during or shortly after birth. Many of the common causes of cerebral palsy can be prevented or reduced in severity if doctors take appropriate steps to intervene. That is why it is so important that doctors who provide prenatal care, labor and delivery care, and postnatal care follow established standards of care.
Common risk factors for cerebral palsy
Premature birth: Nearly half of all children with cerebral palsy were born prematurely. That means anything that increases the risk of a preterm birth also increases the risk of cerebral palsy. Risk factors for premature birth include:
- Multiple births (twins, triplets, etc.)
- Multiple pregnancies within a short period of time (less than six months)
- Mother's age (under 16 or over 35)
- Cigarette, alcohol or drug use
- High blood pressure
- Previous miscarriages, abortions or premature births
- Problems with the uterus, cervix or placenta
Many of these risk factors can be prevented or mitigated with medical intervention. For example, a doctor can advise a mother to stop smoking or perform medical procedures to strengthen the cervix and increase the likelihood of carrying the baby to term.
Infections: Certain infections can increase the risk of cerebral palsy. Infections are also correlated with premature birth, which again increases the risk of cerebral palsy. Catching the infection early in pregnancy and treating it appropriately can reduce the risk to the baby, as can certain medical interventions (such as a c-section).
Fetal Size and Position: Both larger than normal and smaller than normal fetuses can be at increased risk of brain damage and cerebral palsy. An abnormal fetal position can likewise increase the risk of a brain injury during birth.
Vaginal Birth After Caesarean (VBAC): When a mother has previously had a c-section, there is an increased risk that the uterus will rupture during a vaginal birth. Such a rupture can cause the baby's brain to become deprived of oxygen, causing brain damage. Doctors have a responsibility to warn mothers who are considering VBAC of this risk.
Common causes of cerebral palsy
Lack of oxygen to the brain: During labor and delivery, doctors need to closely monitor the baby's heart rate. Some fluctuation is normal, but if the heart rate drops below a certain threshold, there is a danger that the baby's brain is not getting enough oxygen, causing cells to die. Immediate intervention, including a c-section, is needed to minimize the risk of cerebral palsy.
Infant infections: When an infection in the mother's body travels to the baby's body during birth, sepsis or meningitis can result. Meningitis is an inflammation of the membranes surrounding the brain, which can cause brain damage if not treated promptly. Doctors need to proactively test for infections, perform a c-section if vaginal delivery carries the risk of transmitting an infection to the baby, and treat any infections immediately to minimize complications.
Jaundice and kernicterus: Jaundice, a medical condition that causes a newborn's skin to appear yellow, means there is a buildup of a chemical called bilirubin in the baby's blood. Jaundice is fairly common and usually appears within two to four days after birth. If detected promptly, jaundice can usually be treated with no long-term consequences for the baby. If left untreated, the buildup of bilirubin can cause kernicterus, a type of brain damage that can lead to cerebral palsy.
Birth trauma: The labor and delivery process can be traumatic, and doctors need to follow standards of care in order to minimize risk to the baby. A traumatic injury to the head during birth can cause cerebral palsy. For example, if a doctor is not careful when using forceps or a vacuum extractor, the baby's skull can be fractured, causing brain damage.
There are many other circumstances and medical conditions that can lead to cerebral palsy, and it's normal for families to wonder what happened. For many families, the way to get to the bottom of their child's diagnosis is to seek legal help.