The link between cerebral palsy and birth asphyxia (HIE)

Cerebral palsy (CP) occurs in about two of every 1,000 newborn children every year in the United States. This equates to about 10,000 babies and infants diagnosed with the condition each year. About 40% of those cases are severe.

Birth asphyxia and cerebral palsy: an established connection

There are many causes of cerebral palsy. This includes birth asphyxia (hypoxic ischemic encephalopathy), maternal infection, genetic problems, birth trauma, blood clotting issues and fetal malformations. In recent years, the medical community -- including The American College of Obstetrics and Gynecology -- has downplayed birth asphyxia as a cause of CP. Instead, they promote the antepartum problems (problems that occur before labor) as the main causes of CP, meaning that the CP occurs prior to birth. The medical community’s position is not surprising given the fact that birth asphyxia is generally preventable.  

One of the foremost experts on the topic of birth asphyxia/HIE and its role in the development of cerebral palsy is Joseph Volpe. In his highly recognized and authoritative textbook called “Neurology of the Newborn,” Volpe provides significant and solid medical reasoning as to why there is a link between birth asphyxia/HIE and cerebral palsy.  Volpe concludes that: “Indeed, if one considers the six large-scale studies of term infants born in the last 3 decades, the data are remarkably consistent in showing that 17% to 24% of cases of cerebral palsy are related to intrapartum asphyxia.”

The National Institutes of Health further supports the link between birth asphyxia and CP by classifying HIE/intrapartum asphyxia as one of the four types of brain damage that causes cerebral palsy. [The others include: damage to the white matter of the brain (periventricular leukomalacia), abnormal development of the brain (cerebral dysgenesis), and bleeding in the brain (intracranial hemorrhage)].

What exactly is birth asphyxia/ hypoxic ischemic encephalopathy?

Sometimes the stress of labor and delivery causes a temporary interruption in blood flow or oxygen levels to the baby. This is not unusual and generally corrects itself. However, if it continues for a lengthy period of time or is completely cut-off, then birth asphyxia or hypoxic ischemic encephalopathy can occur and cause significant brain damage and cerebral palsy.

Some specific obstetrical emergencies that are most commonly the cause of birth asphyxia include:

• umbilical cord injuries (e.g. the cord gets wrapped around the baby’s neck,  precedes the fetus' exit from the uterus, or becomes compressed)

• problems with the placenta or uterus (e.g. ruptured uterus; placenta previa where the placenta is attached to the uterine wall close to or covering the cervix; or placental abruption where a portion of the placental lining tears away from the uterus) 

• excessively frequent uterine contractions

• elevated fetal heart resting tone in between contractions

• delayed delivery of the baby

• trauma to the baby’s brain during delivery

How do you know if your child suffered from birth asphyxia?

Brain imaging studies like CT scans, PET scans and MRIs, blood tests, electroencephalogram (EEG), ultrasounds and other medical studies help diagnose birth asphyxia and its underlying causes. Some symptoms that may be associated with birth asphyxia include:

• Abnormal umbilical artery blood sample
• Apgar score of 0-3 (or greater) for longer than 5 minutes
• Seizures, coma, decreased muscle tone
• Multiple organ involvement (eg, kidney, lungs, liver, heart, intestines)

What to do if you suspect your child’s cerebral palsy was caused by birth asphyxia

Birth asphyxia is preventable in most cases. If you suspect that your child’s cerebral palsy was due to birth asphyxia and medical professionals’ errors, you may be eligible for compensation. Contact our Michigan birth injury attorneys. Our firm specializes in birth injury cases in Detroit, Grand Rapids, Farmington Hills and other Michigan cities as well as Washington DC and Ohio locations like Columbus, Toledo, Cincinnati and more. E-mail us or call 1-888-419-BABY today for a free consultation.