What causes cerebral palsy?

Cerebral palsy (CP) is a motor disorder caused by an injury or abnormality involving the parts of the brain that control movement. According to the CDC, most cases are congenital, i.e. caused by brain damage which occurred before birth or during the birthing process (1). Unfortunately, many of the complications that lead to cerebral palsy are preventable birth injuries. This means that if a doctor or hospital had behaved more responsibly, the child likely would not have had brain damage or developed cerebral palsy.

The term “birth injury” is broad and encompasses many causes of newborn brain damage, including oxygen deprivation (hypoxic-ischemic encephalopathy), excessive mechanical force/pressure (birth trauma), infections, and much more. If a medical professional or organization fails to do all they reasonably can to prevent such birth injuries and their negligence causes cerebral palsy, it constitutes medical malpractice.

The birth injuries that cause cerebral palsy can be broken down into the following three categories based on the time in which brain damage occurred.

1. Cerebral palsy from problematic development or oxygen deprivation (before birth)

  • Oligohydramnios: Oligohydramnios occurs when the volume of amniotic fluid is lower than normal. This can lead to umbilical cord compression, which impairs the delivery of oxygen and nutrients to the baby and increases the risk of adverse pregnancy outcomes, including cerebral palsy (2).  
  • Maternal infection: Infections such as chorioamnionitis, Group B Strep (GBS), urinary tract infection (UTI), bacterial vaginosis (BV), and herpes simplex virus (HSV) can all be extremely dangerous for a developing baby (3). In addition to the risk of vertical transmission (the baby acquiring an infection from the mother), maternal infections can cause premature birth, which often results in underdeveloped lungs, periods of oxygen deprivation, and other complications that may increase the risk for cerebral palsy and other forms of permanent brain damage (4).
  • Preeclampsia: High blood pressure that emerges during pregnancy, or preeclampsia, can cause constriction of and damage to the vessels in the placenta that supply oxygen-rich blood to the baby. This can lead to cerebral palsy, especially when doctors fail to promptly intervene (5).
  • Premature rupture of the membranes (PROM):  This condition occurs when a mother’s “water breaks” before labor starts. PROM can cause a variety of serious issues, including infection, premature birth, and oxygen deprivation. All of these complications increase the risk of brain damage and cerebral palsy (6).
  • Post-term pregnancy: Towards the end of pregnancy (around the time the baby is typically born), the placenta begins to deteriorate. If a baby remains in the womb for too long, this placental deterioration can threaten the baby’s supply of oxygen. Additionally, the baby may become too large, making delivery difficult and injuries more likely. For this reason, medical professionals often recommend induction of labor between 40 and 41 weeks if a baby has not yet been born (7).

2. Cerebral palsy from oxygen deprivation (hypoxic-ischemic encephalopathy) or trauma during labor and delivery

    • Macrosomia or cephalopelvic disproportion (CPD): Macrosomia (when a baby is much larger than normal) and cephalopelvic disproportion (when the baby’s head cannot safely fit through the mother’s pelvis due to size incompatibility) can both lead to a traumatic delivery and oxygen deprivation, which can, in turn, increase the risk of cerebral palsy (8, 9).
    • Hypoxic-ischemic encephalopathy (HIE): HIE is a brain injury that occurs when there is not enough oxygenated blood flowing to a baby’s brain (i.e. the baby experiences birth asphyxia) (10). Birth asphyxia and HIE can stem from a variety of different complications and medical errors; for more information regarding these causes, click here
    • Use of Pitocin or Cytotec: Pitocin and Cytotec are drugs given to mothers to induce or speed up labor. Sometimes, these drugs can cause excessively strong or frequent contractions (uterine tachysystole/hyperstimulation), which  can deprive the baby of oxygen-rich blood. Hyperstimulation can also cause excessive pressure on the baby’s head, which can cause brain trauma. Both oxygen-deprivation and brain trauma can lead to cerebral palsy (11).
        • Umbilical cord problems:  The umbilical cord is the baby’s lifeline; it carries oxygen-rich blood from the placenta to the baby. Issues such as a prolapsed umbilical cord (where the cord exits the birth canal in front of the baby) or nuchal cord (where the cord gets wrapped around the baby’s neck) can cause oxygen deprivation at birth and result in cerebral palsy (12).
  • Placental abruption: Placental abruption occurs when the placenta separates prematurely from the uterine wall. It can cause dangerous maternal bleeding, which also decreases the supply of oxygen-rich blood to the baby, possibly causing cerebral palsy (13).
  • Uterine rupture: Uterine rupture occurs when the uterus (womb) tears open, potentially expelling the unborn baby out of the womb and into the mother’s abdomen. The baby’s blood supply may quickly become restricted, and cerebral palsy may result (14).
  • Forceps and vacuum extractors: The use of operative tools like forceps and vacuum extractors during delivery put the baby at risk for head trauma during the delivery process. This head trauma can cause brain damage which, in turn, can result in cerebral palsy. Sometimes these tools are helpful, but medical professionals who use them must be highly trained and knowledgeable about the circumstances under which their use should be avoided (15).
  • Prolonged and/or arrested Labor: When labor is prolonged or stalled, the baby may be at risk for injury. Contractions can temporarily reduce the flow of oxygenated blood, and if they go on for too long or become too intense, it can result in HIE, birth trauma, and cerebral palsy (16).

3. Cerebral palsy from complications in the perinatal period

  • Perinatal stroke: Strokes occur when the blood supply to a part of the brain is cut off. The risk of pediatric stroke is highest in the perinatal period (i.e. shortly before, during, or after birth). Brain damage resulting from a stroke can lead to cerebral palsy (17).  
  • Brain hemorrhage: Brain bleeds, or intracranial hemorrhages, are a type of traumatic birth injury. Intracranial hemorrhages can lead to brain damage and subsequently, to cerebral palsy, especially if they are not properly treated (18).
  • Hydrocephalus: Hydrocephalus occurs when there is an excess of cerebrospinal fluid within the brain’s ventricles and/or subarachnoid spaces. This condition can cause swelling, which can lead to permanent brain damage and cerebral palsy (19).
  • Jaundice and kernicterus: In many cases, neonatal jaundice is an easily treatable condition with no permanent consequences. However, if it is not properly treated, too much bilirubin (a byproduct of red blood cells) can build up in the brain. Bilirubin is a neurotoxin, and when it moves into the brain tissue, a condition called kernicterus occurs, which damages the brain and can lead to cerebral palsy (20).
  • Neonatal seizures: Seizures are uncontrolled events caused by abnormal electrical activity in the brain due to brain damage or problems with the brain’s chemistry. Neonatal seizures can damage the brain; the longer a seizure lasts or the more frequently the seizures occur, the worse the brain damage. If seizures and resultant brain damage are severe, they can lead to cerebral palsy (21).

Legal help for cerebral palsy

If your baby suffered any birth complications, including the ones listed above, and has been diagnosed with cerebral palsy, please contact our team of birth injury attorneys at ABC Law Centers (Reiter & Walsh, P.C.). We have numerous multi-million dollar verdicts and settlements that attest to our success, and we will fight to obtain the compensation you and your family deserve. Clients pay nothing unless we win their case.

“Reiter and Walsh goes above and beyond the norm in getting their clients the best possible results. Each client is treated with respect and compassion, and they are truly sensitive to what it means to help a family whose child has been injured.”

-Client review from 11/23/2015

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  1. Causes and Risk Factors of Cerebral Palsy | CDC. (n.d.). Retrieved August 21, 2019, from https://www.cdc.gov/ncbddd/cp/causes.html   
  2. Oligohydramnios (Low Amniotic Fluid): Birth Injury Cases. (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/maternal-medical-conditions/oligohydramnios/ 
  3. Maternal Infections & Birth Injury (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/maternal-infections/
  4. Urinary Tract Infections (UTI) and Bacterial Vaginosis (BV) (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/maternal-infections/urinary-tract-infections-and-bacterial-vaginosis/
  5. Mismanaged Preeclampsia During Pregnancy (n.d.). Retrieved August 21, 2019, from  https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/maternal-medical-conditions/preeclampsia-and-eclampsia/
  6. Premature Rupture of the Membranes (PROM) and Birth Injury (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/maternal-medical-conditions/premature-rupture-of-membranes/
  7. Postterm Pregnancy and Birth Injury(n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/maternal-medical-conditions/post-term-pregnancy/
  8. Macrosomia and Birth Injury (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/traumatic-birth-injuries/macrosomia/
  9. Cephalopelvic Disproportion (CPD) Injuries (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/traumatic-birth-injuries/cephalopelvic-disproportion/
  10. Hypoxic-Ischemic Encephalopathy (HIE) (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/fetus-or-newborn-medical-problems/hypoxic-ischemic-encephalopathy/
  11. Uterine Tachysystole (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/practice-areas-uterine-tachysystole/
  12. Umbilical Cord Problems and Birth Injuries (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/umbilical-cord-problems/
  13. Placental Abruption (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/labor-and-delivery-complications-and-errors/placental-abruption/
  14. Uterine Rupture and Birth Injuries (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/labor-and-delivery-complications-and-errors/uterine-rupture-and-hie/
  15. Forceps and Vacuum Extractor Injuries (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/traumatic-birth-injuriesa/vacuum-extractor-injuries/
  16. Prolonged Labor, Arrested Labor, and Birth Injury (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/traumatic-birth-injuries/prolonged-and-arrested-labor/
  17. Perinatal Stroke (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/types-of-birth-injuries/cerebral-palsy/cerebral-palsy-caused-by-stroke/
  18. Infant Intracranial Hemorrhages (Brain Bleeds) and Birth Trauma (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/traumatic-birth-injuries/intracranial-hemorrhages/
  19. Hydrocephalus and Birth Injury (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/neonatal-birth-injuries/hydrocephalus/
  20. Jaundice and Kerniceterus (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/neonatal-birth-injuries/elevated-bilirubin-jaundice-and-kernicterus/
  21. Neonatal Seizures (Infant Seizures) and Birth Injury (n.d.). Retrieved August 21, 2019, from https://www.abclawcenters.com/practice-areas/neonatal-birth-injuries/seizures/