Cerebral Palsy Causes

Fact Checked

Cerebral palsy is caused by abnormal brain development or brain damage, with many potential underlying causes and risk factors. Cerebral palsy causes include maternal infections, fetal stroke, and excessive use of force on the skull during labor, among many others.[1]

What Is Cerebral Palsy?

Cerebral palsy is a term that describes a group of neurological disorders that causes motor and movement disabilities. It develops in the womb, during childbirth, or shortly after birth.

Early signs of cerebral palsy include floppy or stiff muscles, abnormal posture, and developmental delays. Mild cerebral palsy causes minimal disability, but it can also be moderate or severe and debilitating.

Cerebral palsy is not curable, but it is treatable and does not get worse with age. Understanding what causes cerebral palsy is important for addressing and reducing risk factors, although it is not always preventable.

What Is the Main Cause of Cerebral Palsy?

There are two related underlying causes of cerebral palsy:

• Abnormal brain development. The development of the brain is crucial to normal growth and development. Anything that disrupts the process and causes abnormalities can lead to cerebral palsy.
• Brain damage. Even if the brain develops normally, something may happen to cause physical damage. This can also result in cerebral palsy.

There are many problems that can affect how a baby’s brain develops or suffers damage. For some children, it is never possible to determine an exact cause.

What Causes Cerebral Palsy During Pregnancy and Delivery?

When a baby develops cerebral palsy either before or during birth, it’s known as congenital cerebral palsy. Most cerebral palsy cases are congenital.[2]

Congenital cerebral palsy can develop from numerous causes, but sometimes, the cause remains unknown. Potential causes include:

• Brain damage
• Medical negligence and mistakes
• Brain malformations
• Jaundice
• Maternal infections, such as rubella, chickenpox, and other infections
• Chorioamnionitis
• Prolonged labor
• Incompatible blood types (can lead to Rh factor diseases)
• Asphyxia
• Carrying twins or multiples
• Placenta problems
• Uterine rupture
• Prematurity or low birth weight
• Infertility treatments

What Causes Cerebral Palsy After Birth?

Acquired cerebral palsy is defined as the disorder developing at least 28 or more days after birth. This form of cerebral palsy accounts for around 20% of all people who have the condition.

Common reasons for acquired cerebral palsy include:

• Problems with blood flow to the brain, which can lead to blood clotting and fetal stroke
• Sickle cell disease
• Neonatal infections
• Head injuries leading to brain damage

The Most Common Causes of Cerebral Palsy Explained

Brain Damage

Brain damage is one of the primary causes of cerebral palsy. It can happen before, during, or after birth.

Maternal high blood pressure and infections can lead to abnormal brain development or brain damage while an infant is still in utero. It’s essential to get regular prenatal care and routine medical monitoring while pregnant.[3]

Hemorrhaging is another cause of infant brain damage and is more common in babies born prematurely. Hemorrhages can result after a baby has a problem with blood flow to the brain or reduced oxygen to the brain.

Bleeding inside the brain isn’t necessarily visible, and it isn’t until specific symptoms occur that doctors diagnose it.

In some instances, medical malpractice is the direct cause of infant hemorrhage (see the following section for additional details on medical negligence).

Medical Negligence

Unfortunately, there are some cases of cerebral palsy that could have been prevented if not for medical mistakes and negligence.

In addition to failing to find and diagnose medical problems early in pregnancy to prevent damage, physicians can also significantly impact the causes of brain damage during childbirth.

Although these medical mistakes are not purposeful, the result is that improper medical care of the patient can lead to severe problems.

The most common types of medical mistakes that can lead to cerebral palsy include:

• Failure to identify, schedule, and carry out an emergency C-section
• Failure to monitor infant heartbeat
• Failure to identify, diagnose, and treat umbilical cord issues or placental issues
• Failure to detect and treat maternal infections
• Improper use of forceps or vacuum extraction tools during childbirth
• Failure to get oxygen to an infant in time during childbirth
• Failure to monitor oxygen levels
• Surgical or anesthesia errors

Brain Malformations

Brain malformations are defects that happen when the baby’s brain develops abnormally.

Although it can occur at any time during fetal development, the baby runs the highest risk of developing brain defects before 20 weeks gestation, which may lead to cerebral palsy.[4]

Jaundice

Jaundice results from bilirubin buildup in the blood in the first days to weeks after birth. Some cases of jaundice will clear up independently or with treatment.

When the bilirubin is high and jaundice is left untreated, a form of brain damage called kernicterus may occur, which can lead to the infant developing cerebral palsy.

According to the Centers for Disease Control and Prevention, jaundice affects around 60% of babies born. It’s usually the more severe cases that cause disorders and other medical issues.[5]

Maternal Infections

If not correctly detected and treated, maternal infections such as measles, cytomegalovirus, toxoplasmosis, chickenpox, and certain other diseases can lead to brain damage in the developing infant and increase the risk of cerebral palsy.

According to a study published by the U.S. National Institutes of Health, over 80% of maternal infections “were diagnosed during the birth hospitalization.” [6]

Both intrauterine and extra-uterine maternal infections diagnosed at hospitals were associated with a high instance of babies developing cerebral palsy.

Prolonged Labor

Prolonged labor is labor that lasts longer than 16 to 24 hours. There are many possible complications of prolonged labor, including cerebral palsy. It is associated with the use of instruments, like forceps, which can physically damage a baby’s head.

Prolonged labor is also associated with several complications that can cause brain damage by asphyxiation or deprivation of oxygen.

The complication can include a breech birth, a large baby, the baby getting stuck in the mother’s pelvis or the birth canal, complications with the placenta or umbilical cord, and the failure of a doctor to perform a Cesarean section in time to prevent brain damage.[7]

Rh Incompatibility

Rh incompatibility is a medical condition marked by the mother’s blood and the infant’s blood being incompatible.

The mother’s blood produces antibodies that destroy the infant’s blood cells during late pregnancy or after delivery. This, in turn, can lead to jaundice, which can lead to brain damage and an increased risk of cerebral palsy.

Excessive Force

When labor is prolonged or difficult, a doctor may use too much force to deliver the baby. That force can damage the skull and, in severe cases, damage the brain. 

The risk of excessive force causing brain damage that leads to cerebral palsy is higher when doctors use instruments like forceps and vacuum extractors.

Who Is Most at Risk for Cerebral Palsy?

The following risk factors increase the chances that an infant will have cerebral palsy:

• Breech-position birth (or other unusual positions)
• A low APGAR score (indicating poor cardiac or respiratory function at or right after birth)
• Extreme prematurity
• Infertility treatments
• Low birth weight infant (under 5 pounds)
• Multiple babies
• Delivery complications
• Microcephaly (small head when born)
• Infant seizures (shortly after birth)
• Maternal illicit drug use or exposure to toxins
• Maternal proteinuria (excessive protein in the mother’s urine indicating pre-eclampsia and maternal high blood pressure)
• Maternal seizures (eclampsia)
• Maternal blood clotting disorders
• Maternal hyperthyroidism or hypothyroidism
• Maternal infections, including rubella, herpes, syphilis, toxoplasmosis, Zika virus, and cytomegalovirus

Certain illnesses and medical conditions in the newborn can also increase their risk of developing cerebral palsy: 

• Bleeding in the brain, often caused by a stroke
• Viral encephalitis
• Bacterial meningitis

Keep in mind that not all infants exposed to these risk factors will develop cerebral palsy. Yet, it’s always important to be aware of potential contributors to the development of the disorder.

Is Cerebral Palsy Genetic?

Cerebral palsy is not considered a genetic disorder, meaning there is no single gene or combination of genes that ensures a child will develop it.

However, recent research has linked some cases of cerebral palsy to specific genes. A study published in 2020 reported that approximately 14% of cases are related to genes that control the early development of the brain.[8]

These findings improve the understanding of cerebral palsy’s causes, but it remains a complicated condition. Having one or more of these gene mutations does not guarantee a child will be diagnosed with cerebral palsy, but it likely increases the risk.

Tips to Help Prevent Cerebral Palsy

With so many potential risks and causes of cerebral palsy, it seems overwhelming to many parents. However, there are numerous steps you can take during pregnancy to give your baby the best chance of avoiding a diagnosis of cerebral palsy.

• Keep all of your prenatal appointments. Routine medical care can pick up on issues that are easier to address early.
• Make sure your vaccinations are up to date, specifically chickenpox, measles, and rubella vaccinations.
• Blood type is essential. Remember that Rh incompatibility can lead to medical issues that can cause cerebral palsy. Your physician can treat Rh incompatibilities if caught early on, which can help prevent jaundice and kernicterus.
• Avoid harmful substances like alcohol, tobacco, and illicit drugs.
• Stay healthy at all times. You can also start prevention before pregnancy by staying as healthy as possible, and by eating and sleeping well.
• Keep your new baby safe. In some cases, cerebral palsy develops after birth. Take precautions to prevent your baby from developing jaundice, and get treatment right away if they do. Keep your baby up to date on infections. It’s also important to protect babies from physical trauma by baby-proofing the home, using appropriate child car seats, and other measures.

It’s not always possible to prevent cerebral palsy, even when the mother does everything right. The best thing you can do for a baby with cerebral palsy is to talk to your doctor and start interventions right away.

What Is the Life Expectancy of Cerebral Palsy?

Life expectancy for a baby with cerebral palsy is as varied as for anyone else. It is largely determined by associated conditions and complications rather than cerebral palsy itself.

Cerebral palsy is not progressive, but some of the complications are. Associated conditions like difficulty feeding or epilepsy can negatively impact overall health.

Treatment also impacts life expectancy. Early interventions and treatments that address associated conditions make a big difference.

Contact a birth injury lawyer if you believe the cause of your child’s cerebral palsy is related to medical negligence. They can help you take legal action and recover damages.