Premature Birth and Cerebral Palsy

Fact Checked

Premature birth is when a child is born before the gestation period is complete or before the projected due date. Babies born early are at risk for a variety of complications and health problems, including long-term or permanent disabilities like cerebral palsy. Doctors must make pregnant women aware of the risks of having a baby prematurely and help them take preventative measures.

What Is Premature Birth?

Premature birth is when a baby is born before its expected due date. More specifically, it refers to a delivery three weeks or more before the due date. There is a healthy and normal window for a child to be born around the calculated due date. The more premature a baby is, the higher risk of complications.

A typical gestation period for a woman is 40 weeks, so any birth earlier than 37 weeks is considered premature. Prematurity can be further subdivided into more specific categories. A moderately preterm baby is born between 32 and 36 weeks; a very preterm baby is born before 32 weeks, and an extremely preterm baby is born before 28 weeks.

Causes of Premature Birth

For most individual cases, there is no real cause to be pinpointed for premature birth. There are, however, several risk factors, things that are well documented to increase the risk that a baby will be born early.

One risk factor is when a woman has previously had a baby prematurely. This indicates that she is at high risk of delivering prematurely in future pregnancies.[1] Being pregnant with multiples is also a significant risk factor for premature birth, as is getting pregnant six months or sooner after a previous delivery.

Complications or reproductive health issues can cause a woman to deliver prematurely, including placental complications and problems with the cervix or uterus.

When a pregnant woman does not get adequate nutrition or makes unhealthy lifestyle choices, such as smoking, drinking, or abusing drugs, she is more likely to deliver prematurely. Infections in the mother, a physical injury, or a stressful occurrence, all increase the risk of premature birth.

Complications of Premature Birth

Premature birth is a known risk factor for cerebral palsy. There are many ways it can cause cerebral palsy, even if the cause for a particular individual cannot be determined. Most likely, a premature birth will cause some type of complication, leading to the damage that causes cerebral palsy.

There also may be several factors at work that ultimately lead to the condition.

In the short term, a baby born prematurely may have respiratory problems, heart problems, difficulty controlling body temperature, gastrointestinal problems, and complications with the immune system and blood. A baby may also have complications that affect the brain.[2]

These small, early babies are at risk for bleeding in the brain, and in severe cases, for accumulating fluid on the brain. These brain complications can cause lasting brain damage associated with cerebral palsy.

The Cerebral Palsy-Premature Birth Connection

A number of studies have found that being born prematurely is a major risk factor for cerebral palsy. The risk is especially high for babies born earlier than 32 weeks.

Premature birth is a risk factor, but it does not mean that all premature babies will develop the condition. On the other hand, it is known to be a serious risk factor because about half of all children diagnosed with cerebral palsy were born prematurely.

Low birth weight is also a risk factor for cerebral palsy, and premature babies are likely to have low birth weights.[3] One recent study found that prematurity, when combined with low birth weight and preeclampsia in the mother, increased the risk of a child having cerebral palsy 20-fold.

It is clear that premature birth is a significant risk factor for cerebral palsy and that more than one risk factor and co-occurring risk factors related to each other increase the risk even more. One study found that even when babies are born only a little bit early, such as at 37 or 38 weeks, there is a slightly increased risk for cerebral palsy.

Prevention

Sometimes, it is impossible to determine if a woman will deliver prematurely until it happens. However, there are known risk factors, and if those can be avoided or addressed, a woman can decrease the risk that her baby will come early and be at a higher risk for cerebral palsy.

At particular risk are women who have previously had preterm babies. Waiting 18 months for the subsequent pregnancy, quitting smoking, promptly treating infections and good control of other health conditions such as diabetes is extremely important.

Doctors must carefully monitor women who have already had one premature baby. There are even treatments that can be used to try to prevent another premature birth. These include progesterone supplementation and cervical procedures when medically indicated.

For women who have less obvious risk factors, but also for those with no known risk factors, steps can be taken to reduce the risk of premature birth. These include eating a healthy diet, keeping up with doctor appointments and checkups, avoiding stress, and avoiding smoking and drinking.

Premature Birth and Medical Negligence

Not all premature births are preventable. It is not always possible to know exactly what caused a baby to be born early. On the other hand, with everything we know about risk factors, doctors can monitor their patients for these risk factors and help them take reasonable preventive measures.

For instance, if a woman previously had a premature baby, her doctor should monitor her very closely and check on the fetus’s development and health.

When a doctor does not take the reasonable and expected steps to address the risk factors for premature birth, there can be far-reaching consequences. If your baby was premature and developed cerebral palsy, you may have reason to think that medical negligence played a role.

If you don’t think your doctor did all that was necessary to protect your baby, consult with a cerebral palsy lawyer to help you make a case.