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Jeff Brody
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Risk Factors for Cerebral Palsy

While there are no certainties in diagnosing cerebral palsy in the newborn, there are some risk factors that should be taken into consideration when attempting to make a diagnosis.  The three main factors for the highest risk children are premature babies delivered who do not cry within the first five minutes after delivery, babies who need to breathe on a ventilator for over four weeks and babies who have bleeding in the brain.  Newborns with poorly formed organs like the heart, kidneys, and spine are also more at risk for developing cerebral palsy most likely because of the likelihood of a badly formed brain in conjunction with the other organs.  If a newborn has seizures, this also increases the risk of developing cerebral palsy.  While these risk factors are common in the development of CP, there are many instances of newborns with these various ailments recovering with full health and, conversely, many instances of newborns with none of these risk factors who do go on to develop cerebral palsy.

Another risk factor that seems to play a role in babies who develop CP is the health and social habits of the mother.  In rare cases if the pregnant mother has a severe physical trauma the brain of the fetus could be affected.  The brain of the fetus is at risk when other factors such as alcohol use, cigarette smoking, malnutrition, and use of cocaine or crack can all be contributing factors in the development of a baby who will eventually have cerebral palsy.  Heavy alcohol use during pregnancy has been shown to damage fetal organs.  Cigarette smoking by the mother can lead to a low birth weight, which is also associated with cerebral palsy.  Basically, any factors that may affect the fetus’ weight (which ultimately affects its brain size), or brain, are suspect in making a cerebral palsy diagnosis. 

Several infections in the expectant mother such as rubella (German measles), toxoplasmosis, and cytomegalovirus (CMV) may all contribute to brain damage and eventually cerebral palsy in a newborn as well.  Expectant mothers should be immunized against rubella before becoming pregnant.  The possibility of getting toxoplasmosis can be minimized by the avoidance of cat feces and not eating uncooked meat.

Blood disease in the mother also plays a risk in the development of cerebral palsy.  An incompatibility issue between the blood of the mother and her fetus can cause jaundice and brain damage, which may result in cerebral palsy.  This is termed Rh disease, and can usually be prevented with an injection of Rh immune globulin by the pregnant mother in her 28th week.  The injection will be repeated after the birth.  Severe jaundice in an infant or fetus can also lead to the development of cerebral palsy.
 
Premature births have a greater risk of cerebral palsy as well.  The birth weight also seems to play a role in the child’s development of CP, the less the newborn weighs and the more premature the birth, the higher the chance of the infant developing cerebral palsy.  Infants born with a very low birthrate (i.e. under 3 pounds 5 ounces, or 1500 grams) have a 25 times more likely chance of acquiring cerebral palsy.

Some babies may develop cerebral palsy due to medical mistakes and have the disease because of some accident that occurred before, during, or even after the birth of the child.  Some of these mistakes are due to:  prolonged birth canal exposure leading to oxygen deprivation, the failure by a doctor to recognize seizures in the newborn, an undetected prolapsed cord, overuse of vacuum extraction, misuse of forceps, not doing a cesarean section when the fetus is in distress or danger, failure to respond to abnormal heart rates, failure to recognize or treat jaundice, meningitis or high blood pressure in the mother.

Other risk factors for cerebral palsy include:  the mother is over 40 years old or under 20, the father is under 20, African American ethnicity, the child is either a firstborn or fifth-born, and if the child is one of a twin, and especially if the other twin had died.  It should be noted that these are risk factors, and not determinants, of cerebral palsy.  The conjunction of several of these factors may increase the chances as well.  However, there is no sure way of predicting cerebral palsy, or even preventing cerebral palsy

 

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