Birth Asphyxia and Cerebral Palsy

Fact Checked

Asphyxia at birth is one cause of cerebral palsy. Asphyxia is oxygen deprivation, a serious medical condition that can lead to death if not treated immediately. Quick treatment can limit the resulting brain damage that could cause cerebral palsy.

What Is Birth Asphyxia?

Birth asphyxia is oxygen loss and blood supply loss to the baby and generally occurs shortly before or during birth. It accounts for around 6% to 8% of all cerebral palsy cases.

There are several potential causes of birth asphyxia: 

• Umbilical cord issues, including the cord wrapping the baby’s head, a compressed or restricted cord, and similar problems
• Heavy maternal bleeding and fetal distress leading to maternal shock
• Abnormal birth presentation, such as the baby being in the breech position, which complicates delivery
• Large infant size, including a larger head, which may prolong delivery
• Infant or maternal high or low blood pressure
• Infant’s airways are unformed or blocked
• Anemia

While babies are still in the womb, they rely on their mother’s blood carried through the umbilical cord for oxygen.

This oxygen-rich blood flows from the placenta into the umbilical cord, nourishing the infant. If anything affects the oxygen-rich blood, it can negatively affect the infant’s health.

Other causes of birth asphyxia include placental issues, such as placenta previa and placental abruption. Umbilical cord problems can also lead to birth asphyxia, such as the baby getting tangled in the cord or umbilical cord compression.[1]

Does Asphyxia Cause Brain Damage?

When a baby is deprived of oxygen, the pH levels and blood gas levels are usually altered, which places the infant at a heightened risk for cerebral hypoxia. This can lead to brain damage.[2]

A baby can have less glucose and several essential nutrients during this stage. This can cause waste matter to remain in the infant’s brain, creating the potential for additional medical problems.

The severity of an infant’s brain damage depends on how severe the birth asphyxia is, how long they’re deprived of oxygen, the age of the infant (newborns born prematurely run a much higher risk of developing brain damage if deprived of oxygen), and how the staff handles the situation.

If birth asphyxia causes brain damage during birth, the baby usually develops hypoxic-ischemic encephalopathy (HIE) shortly after being born. HIE is a specific type of brain damage caused by low oxygen or lack of oxygen. HIE is one of the leading causes of infant mortality or severe impairments after birth.

For more information on HIE, refer to our article Cerebral Palsy and Hypoxic Ischemic Encephalopathy (HIE).

Does Birth Asphyxia Cause Cerebral Palsy?

Asphyxia does not always cause cerebral palsy. Even when it is a contributing factor, lack of oxygen may not be the only cause.

However, researchers have found a definite connection between the two, indicating that asphyxia at birth increases the risk of developing cerebral palsy.

A large study that reviewed other studies found that the incidence of cerebral palsy is significantly higher in babies with perinatal asphyxia.[3] This refers to a lack of oxygen within a few weeks of birth.

Birth Asphyxia Symptoms and Diagnosis

Because asphyxia in newborns and during delivery can be so damaging, it’s important to recognize and treat the signs of oxygen deprivation immediately.

Doctors look for numerous symptoms when diagnosing birth asphyxia, including:

• Skin color may be blue or pale
• Low heart rate
• Poor muscle tone
• Weak reflexes
• Meconium (baby’s first stool) mixed into the amniotic fluid
• Infant seizures
• The baby may have breathing difficulties or not breathing at all
• Unalert or low level of alertness
• Hypotonia (the baby’s body is floppy and limp)

However, babies born prematurely have a less mature nervous system when compared to full-term babies and subsequently may not have all of the above symptoms or any of the signs at all.

When diagnosing asphyxia at the time of delivery, physicians and medical staff rate the baby’s health on a scale from 0 to 10.

The Apgar Score allows healthcare providers to rate the baby’s heart rate, skin color, reflexes, muscle tone, and breathing. An extremely low Apgar Score of 0 to 3 could indicate birth asphyxia.

Birth Asphyxia Treatment Options

There are several ways that birth asphyxia is treated. These can prevent cerebral palsy or reduce its severity. Standard treatment options include:

• High-frequency Ventilation. This treatment option sends small puffs of pure oxygen into the infant’s lungs via mechanical ventilation.
• Hypothermia. Hypothermia involves reducing the baby’s internal body temperature to 33.5 degrees C for around 72 hours.
• Nitric Oxide. Inhaled nitric oxide is provided by a breathing tube placed directly into the baby’s windpipe to help lower blood pressure and open the blood vessels in the lungs.
• Extracorporeal Membrane Oxygenation (ECMO). ECMO involves using a heart/lung pump, which provides temporary life support for the baby. It also removes excess carbon dioxide from the infant’s body while supplying additional oxygen. Babies must be under sedation while receiving this treatment.

What Is the Prognosis for Babies with Asphyxia at Birth?

Not all babies who experience birth asphyxia will develop brain damage. If brain damage occurs, treatment can lessen the severity of the complications.[4]

Infants who have moderate to severe brain damage can develop medical conditions that require long-term treatment, such as seizures, issues with multiple organs, breathing problems, social issues, learning disabilities, cognitive dysfunctions, and behavioral issues.

Again, treatment must begin as soon as possible, which may help eliminate other medical issues.

Does Medical Negligence Cause Asphyxia?

Unfortunately, many birth asphyxia cases could have been prevented with the proper medical measures. While usually not intentional, medical negligence and mistakes still happen far more often than they should. As a result, babies are left with lifelong disorders such as cerebral palsy.

For example, umbilical cord problems are one of the top reasons that birth asphyxia occurs–if a physician fails to monitor infant distress, the umbilical cord issues become worse.

Failure to monitor fetal distress can also lead to doctors not knowing when to perform an emergency C-section, leaving the infant in utero for too long.

Shoulder dystocia is another common problem that leads to birth asphyxia, but in some instances, doctors fail to utilize proper maneuvering methods to deliver the infant faster and safer.

Essentially, failing to notice prior problems and act accordingly to prevent birth asphyxia may be seen as medical negligence and malpractice.

What Can I Do About Negligent Birth Asphyxia?

If you think your child suffered oxygen deprivation during birth, contact an experienced birth injury lawyer. They can review your case and determine if negligence played a role. The right lawyer will give you legal options and help you seek justice for your child.