Cerebral palsy is the most common childhood disability, affecting approximately three out of every thousand live births in the United States.[1] A disorder that affects a person’s ability to move and maintain balance and posture, cerebral palsy (CP) is caused by abnormal brain development or damage to the developing brain that affects an individual’s ability to control their muscles. While CP can arise during the first years of a child’s life, 85% to 90% of CP cases are congenital, occurring before or during birth, so it’s natural to wonder how preventative CP is.[2] Is it pure bad luck, or is someone or something to blame? While the answer to this question of course varies from case to case, there are some patterns to be found and common risk factors to be aware of. Before declaring malpractice, review our synopsis below of the risk factors that can increase an infant’s chances of developing congenital cerebral palsy as well as how best to prevent it.
Causes
While many used to believe that CP was typically the result of a lack of oxygen or other complications during the birth process, it is now widely agreed that birthing complications only account for a small percentage – 10% – of cerebral palsy cases.[3] The abnormal brain development that we now know causes CP can be the result of accidents, genetic abnormalities, medical malpractice, negligence, infections, and injury.[4]
Risk Factors
There are many things, controllable and uncontrollable, that can increase the chance of a fetus or infant developing cerebral palsy. Here are some of the most common risk factors:
- Low birth weight: Children weighing less than 5 ½ pounds at birth, especially those weighing less than 3 pounds, have a greater chance of having CP.[5]
- Premature birth: Though intensive care for premature infants has improved significantly over the past several decades, children born before the 37th week of pregnancy are more likely to have medical problems that put them at risk for CP.
- Multiple births: Twins, triplets, and other multiple births are at a greater risk of developing CP, largely because these children are often born early, with low birth weight, or both.[6]
- Infertility treatments: Children conceived with infertility treatments are at a greater risk of CP, mostly due to the fact that they are more likely to be delivered preterm or be part of a multiple pregnancy.
- Maternal infection: Because a fetus relies on its mother’s blood for nutrition, anything that affects her blood will also affect the fetus’ blood.[7] Infections like meningitis, rubella, cytomegalovirus, and pneumonia, can target cerebral development and inflame or damage the fetus’ brain.[8]
- A kinked or prolapsed umbilical cord: This is one instance where oxygen deprivation can cause CP; problems with the umbilical cord can cause brain damage in an infant, and therefore CP.[9]
- Medical conditions of the mother: A child has a slightly higher risk of having CP if their mother has thyroid problems, an intellectual disability, or seizures.[10]
- Jaundice and kernicterus: When severe jaundice – which occurs when a chemical called bilirubin builds up in a baby’s blood – is untreated, it can cause a condition called kernicterus, which can cause CP and other conditions.[11]
- Forceful delivery: The misuse of medical tools like forceps or vacuums to assist with birth can cause brain trauma that results in CP.[12]
Prevention Methods
It’s important to know that good prenatal care can lower the risk of cerebral palsy, but cannot entirely prevent it; the causes of congenital CP aren’t fully known and CP related to genetics is not preventable.[13] However, here are some actions that can be taken before and during pregnancy to reduce the risk of a child developing CP:
- Administer early and regular prenatal care: In order to minimize risk factors and ensure the health of both mother and developing baby, mothers should be sure to get regular care as soon as the pregnancy is known.
- Mothers should be vaccinated: In addition to generally being as healthy as possible, mothers should be vaccinated for certain diseases that could harm a developing baby.
- Infertility treatment planning: If a couple uses assistive reproductive technology to get pregnant, doctors should encourage mothers to consider ways to reduce the chance of a multiple pregnancy.[14] One option is to transfer only one embryo at a time.
- Discuss ways to prevent problems if there is a risk of preterm delivery: Both doctors and mothers need to prioritize talking about ways to minimize the risks of preterm delivery, and therefore CP.
Cerebral palsy has no cure; a single misstep can result in a life completely and forever changed, and the potential necessity of life-long care. Responsibility can lie with several different parties or none, but regardless, proactive measures are necessary in order to eliminate this disability.
[1] “Data & Statistics for Cerebral Palsy,” CDC.gov, May 2, 2016, https://www.cdc.gov/ncbddd/cp/data.html
[2] “Causes and Risk Factors of Cerebral Palsy,” CDC.gov, Jan. 16, 2015, https://www.cdc.gov/ncbddd/cp/causes.html
[3] “Definition of Cerebral Palsy,” cerebralpalsy.org, http://www.cerebralpalsy.org/about-cerebral-palsy/definition
[4] Ibid
[5] “Causes and Risk Factors”
[6] Ibid
[7] “What Kind of Malpractice Can Cause Cerebral Palsy?” KenedyHodges.com, n.d., http://www.kennedyhodges.com/faqs/common-malpractice-causes-of-cerebral-palsy.cfm
[8] “Causes and Risk Factors”
[9] “Cerebral Palsy Causes,” birthinjurycenter.com, n.d., http://birthinjurycenter.com/cerebral-palsy-causes/
[10] “Causes and Risk Factors”
[11] Ibid
[12] Wieand, Brent, “5 Common Birth Injuries Caused by Malpractice,” WieandLaw.com, Nov. 29, 2015, http://www.wieandlaw.com/5-common-birth-injuries-caused-by-malpractice/
[13] “Causes and Risk Factors”
[14] Ibid