Premature Birth and Cerebral Palsy
This article has been fact checked by a Board Certified Pediatrician. Sources of information for the article are listed at the bottom.
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Premature birth refers to a situation in which a child is born before the gestation period is complete, or ahead of the projected due date. Babies that are born early are at risk for a variety of complications and health problems, including long-term or permanent disabilities like cerebral palsy. What exactly causes a baby to be born prematurely is not always known, but there are risk factors like smoking, multiple pregnancies, and reproductive health problems.
Women who are pregnant should be aware of the risks of having a baby prematurely, and what the risk factors are to be able to take reasonable steps to prevent them. Pregnant women also rely on their doctors to inform and guide them to take all the steps that are possible to have a healthy pregnancy and to minimize the risks of premature birth and cerebral palsy.
What is Premature Birth?
Premature birth is when a baby is born before its expected due date. More specifically it refers to a birth that is 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 a premature birth. There are, however, a number of risk factors, things that are well documented to increase the risk that a baby will be born early. A very important risk factor is when a woman has previously had a baby prematurely. This indicates that she is at a high risk for delivering prematurely in any future pregnancies. Being pregnant with multiples is also an important risk factor for premature birth, as is getting pregnant six months or sooner after a previous delivery.
Complications or issues of reproductive health 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 in which 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 which in turn leads 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. 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 possibly 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. 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 an important risk factor for cerebral palsy and that more than one risk factor and co-occurring risk factors that are 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.
Sometimes it is not possible 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 that it will be at a higher risk for cerebral palsy. At particular risk are women who have previously had preterm babies. Waiting 18 months for the next pregnancy, quitting smoking, promptly treating infections and good control of other health conditions such as diabetes are extremely important. Women with one premature baby need to be monitored carefully while pregnant. 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 a premature birth. These include eating a healthy diet, keeping up with doctor appointments and checkups, avoiding stress, and avoiding things like 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 do have an ability to monitor their patients for these risk factors and to help them take reasonable preventive measures. For instance, if a woman previously had a premature baby, her doctor should be monitoring her very closely and checking on the development and health of the fetus.
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.