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Cerebral palsy risk factors include birth complications, preterm births, maternal illnesses, and more. Risk factors do not cause cerebral palsy, but they do increase the risk of a baby developing cerebral palsy. Controlling for risk factors can help mothers and physicians get better outcomes for babies.
What Causes Cerebral Palsy?
The cause of cerebral palsy is brain damage or abnormalities in the brain. These are broad causes with many potential underlying causes.
It isn’t always possible to pinpoint what caused the brain damage. However, doctors know of several factors that increase the risk a child will have the type of damage that could lead to cerebral palsy.
Risk Factor #1: Birth Complications
Complications during the delivery process that disrupt the oxygen supply can cause brain damage and increase a baby’s chances of developing cerebral palsy.[1]
In the past, birth complications were believed to be the only cause of cerebral palsy, but modern research has uncovered numerous factors.
Birth complication risk factors include:
- Low birth weight
- Prematurity
- Infertility treatments
- Medical conditions of the mother, such as thyroid problems or seizures
- Not having enough oxygen during the delivery process
- Abnormal delivery position, such as the breech position
- Placental problems, including the placenta detaching too early
- Improper use of forceps and other birth-assisted tools during delivery
- Membranes rupturing too early
Risk Factor #2: Infections
Certain maternal and fetal infections can heighten the risk of an infant developing cerebral palsy, especially if not treated promptly. The most common infections that increase the risk include:
- Sexually transmitted diseases, such as herpes and syphilis
- Rubella
- High fever
- Bacterial infections
- Toxoplasmosis
- Chickenpox
Risk Factor #3: Blood Type Incompatibility and Jaundice
Blood type and Rh incompatibility occur when the mother’s blood type differs from her infant’s and is incompatible.[2] For example, a mother with Type O blood may be incompatible with a child with Type A, B, or AB blood.
This can lead to jaundice or a yellowing of the skin when a substance called bilirubin builds up in the blood. This can eventually lead to a condition called kernicterus that may cause brain damage if not treated.
Red blood cells can then break down, leading to elevated bilirubin levels when there is an ABO incompatibility.
Rh incompatibility occurs when a mother is Rh-negative and the newborn is Rh-positive. The mother makes antibodies that attack the newborn’s red blood cells and can lead to other problems besides jaundice. Rh incompatibility is preventable with a special treatment called RhoGAM that the mother receives at 28 weeks of gestation.
Rh or blood incompatibility doesn’t always mean that a baby will develop cerebral palsy. Still, it’s a risk factor, and therefore, a blood compatibility test should be carried out during early pregnancy or after childbirth if your baby develops jaundice.
Blood incompatibility is not the only cause of jaundice. It is fairly common in newborns and is highly treatable if detected early.
Risk Factor #4 Multiple Births
Carrying twins or multiples has been linked to a higher chance of infants developing cerebral palsy due to numerous complications. These include:
- Premature delivery
- Low birth weight
- Breech birth position
Infertility treatments can be a risk factor for cerebral palsy because they increase the risk of multiple births.
Risk Factor #5 Fetal Growth Restriction
Fetal growth restriction, also known as intrauterine growth restriction (IUGR), occurs when a baby falls below the 2.5 percentile compared to other infants the same age. Fetal growth restriction is associated with an increased risk of cerebral palsy.[3]
Fetal growth restriction can be caused by several factors, including:[4]
- Fetal genetic anomalies
- Fetal infections
- Maternal heart disease
- Gestational diabetes
- Maternal alcohol and illegal substance use
- Uterine malformations
- Placental anomalies
- Umbilical cord anomalies
- Inadequate nutrition
- Smoking during pregnancy
In addition to a heightened risk of developing cerebral palsy, fetal growth restriction is one of the leading causes of perinatal death.
Risk Factors Are Not Symptoms Or Causes of Cerebral Palsy
It’s important to understand that risk factors are not signs or symptoms of cerebral palsy. For example, a baby born prematurely isn’t a symptom of the disorder like spastic movements are. Risk factors are simply factors that may be associated with cerebral palsy.
The more risk factors a baby has, the greater their chances of developing cerebral palsy. However, not every baby that develops cerebral palsy has many or all risk factors. Some risk factors, like prematurity, appear more important than others.
Furthermore, risk factors are also not causes of cerebral palsy. For instance, cerebral palsy can be caused by brain damage, but a difficult delivery and oxygen loss during delivery are risk factors that can lead to brain damage.
How to Reduce Cerebral Palsy Risk Factors
In most cases, cerebral palsy is multifactorial, with multiple risk factors present. Most mothers take every step possible to ensure a healthy pregnancy by avoiding modifiable risk factors such as smoking, alcohol, obesity, and infections.
However, not all risks are avoidable. Physicians can make legitimate mistakes, and sometimes there is negligence. There are different things to keep in mind that will help you avoid risk factors, which include:
- Always keep prenatal appointments, and ask your doctor about any potential risk factors they may notice during routine exams.
- Don’t drink alcohol, take illegal drugs, or smoke during pregnancy.
- Avoid exposure to known toxins.
- Ask for a blood compatibility test to be performed as early as possible during pregnancy.
- Avoid harmful household products
Cerebral Palsy Risk Factors Facts and Statistics
According to the Centers for Disease Control and Prevention (CDC):
- Infants are at a greater risk of developing brain damage via risk factors when compared to older children.
- Multiples are five times more likely to develop cerebral palsy when compared to single babies.
- Babies born via in vitro fertilization are 1.6 times more likely to develop cerebral palsy, typically because babies born with this method tend to have lower birth weight or are born as multiples.
Be aware of risk factors if you are pregnant or trying to conceive. Keep regular medical appointments and talk to your doctor about your concerns. The healthier you are, the better your chances of having a healthy baby.
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- Centers for Disease Control and Prevention. (2023, October 6). Causes and Risk Factors of Cerebral Palsy.
Retrieved from: https://www.cdc.gov/ncbddd/cp/causes.html - Sobel, I.P. and Wilhelm, H.S. (1951, April). The Role of Rh Factor in the Etiology of Cerebral Palsy. J. Pediatr. 38(4), 447-51.
Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S0022347651800258 - Kuehn, B. M. (2013). Fetal Growth Restriction, Inflammation Linked to Cerebral Palsy. JAMA, 310(16), 1666.doi:10.1001/jama.2013.281119.
Retrieved from: https://jamanetwork.com/journals/jama/article-abstract/1758729 - Chew, L.C. and Verma, R.P. (2023, August 8). Fetal Growth Restriction. StatPearls. National Institutes of Health.
Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK562268/