PREVENTING CEREBRAL PALSY
Approximately 5000 new cases of cerebral palsy are reported each
year in the United States. Great controversy surrounds the cause(es) of
cerebral palsy. Various authors have suggested that maternal trauma,
bacterial infection, viral exposure, oxygen deprivation prior to or
during birth, cigarettes, and plethora of unknowns can cause cerebral
palsy.
In a great majority of the cases (over 50%) no specific cause for
cerebral palsy can be found. It is known that the greatest predictor of
cerebral palsy is prematurity (pre-term labor is defined as the
appearance of contractions and dilatation before 37 weeks gestation).
Maternal trauma during pregnancy as well as bacterial/viral exposures
to the fetus inutero are suspected of being significant contributors to
cerebral palsy. Great controversy surrounds the percentage of cerebral
palsy caused by physician or nurse errors during labor and delivery.
Some authors have suggested that there is no proof that oxygen
deprivation during labor and delivery can cause cerebral palsy. The
great weight of the evidence on this question, however, suggests that
up to 5% of cerebral palsy (250 cases a year in the United States) are
the result of physician or nurse errors during labor and delivery.
Because some of the mechanisms capable of causing cerebral palsy are
known, certain causes of cerebral palsy may be preventable, avoidable
or treatable. These include:
- Jaundice in newborn infants can be treated with photo
therapy. Jaundiced infants are exposed to blue lights that break
down bio pigments, thus preventing them from building up and
threatening disruption of brain chemistry. In rare cases where this
treatment is not enough, physicians can correct the condition with a
special type of blood transfusion.
- Rh (blood factors)
incompatibility can be identified by a simple blood test routinely
performed during early pregnancy on mothers, and if indicated by
history, expectant fathers. Blood typing compatibility does not usually
cause problems during a woman’s first pregnancy, as the mother’s body
does not produce the unwanted antibodies until after the first
delivery. There are exceptions to this.
- Severe trauma
during delivery (e.g. high/mid-forceps, vacuum extraction, aggressive
manual rotation, excessive fundal pressure, etc.) can cause skull
fractures and/or intra ventricular hemorrages in the fetal/newborn
brain. These traumas and/or hemorrhages can cause oxygen deprivation or
damage to the cerebral cortex of the newborn’s brain, resulting in
cerebral palsy.
- Some evidence exists that oxygen
deprivation during labor and delivery, whether the result of neucal
cord, protracted labor, etc. can cause damage to the fetal/newborn’s
cerebral cortex, resulting in cerebral palsy.
- Infectious
exposures such as rubella or German measles can be prevented if moms
are vaccinated against these diseases before becoming
pregnant. Regular pre-natal care and good nutrition, although not
directly related to the eliminating of cerebral palsy, are always
suggested.
- It is known that cigarette smoking may lead to
small babies and premature deliveries and alcohol/drug consumption can
lead to Fetal Alcohol Syndrome and other types of brain damage.
Accordingly, physicians should advise their patients to avoid these
behaviors during pregnancy.
- The role of environmental
exposures is controversial. Because such exposures tend to be multiple
and not single, providing causation is very problematic.
<back
Please send any question concerning this web page to: bdusevic@c2law.com
© 1999 CHARFOOS & CHRISTENSEN, P.C. Updated: January, 2011
