What causes cerebral palsy?
Cerebral palsy (CP) is a group of motor disorders caused by an injury or abnormality in the parts of the brain that control movement. While some cases of CP are congenital (exist at birth or inherited), many are caused by preventable birth injuries. In these situations, the child likely would not have developed cerebral palsy if a doctor or hospital staff had acted more responsibly.
The term “birth injury” applies to many causes of newborn brain damage, including oxygen deprivation (hypoxic-ischemic encephalopathy or HIE), excessive mechanical force/pressure (birth trauma), infections in newborns, and much more. If a medical professional or hospital fails to prevent birth injuries and their negligence causes a child to have cerebral palsy, it is considered medical malpractice.
Brain injury causes cerebral palsy in children
Cerebral palsy affects the communication between the brain and the body. When a child has cerebral palsy, the parts of the brain that tell their body how to move are damaged, resulting in motor disability. The underlying brain injury that causes cerebral palsy can also sometimes have other effects on the brain, such as cognitive or language-related limitations. Cerebral palsy, however, refers only to a disorder in motor function.
Not every child with a brain injury will have cerebral palsy; it depends on the location and extent of their injury. Some children may not have motor deficits, but can have other issues like hearing or vision problems, behavior problems, or cognitive and learning disabilities.
Brain damage that leads to cerebral palsy can be caused by birth injuries. When a baby does not get enough oxygen during labor and delivery, this can cause a brain injury called HIE. These brain injuries can be prevented if doctors and medical staff recognize and treat complications and deliver the baby in time.
When a brain injury is suspected, brain imaging is taken within 12-24 hours and after. The imaging usually needs to be repeated because the appearance of the injury can change over days, weeks, and even months. The timing and progression of a child’s brain injury is important.
Doctors and medical staff must recognize the signs of a brain injury early on and treat it immediately, usually with hypothermia (cooling) therapy. The worse a brain injury, the more serious the outcomes will be. Cerebral palsy in children can be the result of a birth injury which was not avoided with a timely delivery.
Causes of cerebral palsy before birth
Sometimes, cerebral palsy in a child can be caused by problems that develop during the prenatal period – the stage of pregnancy before labor and birth. Both the mother and the baby must be closely monitored to determine if the baby is getting enough oxygen. If these issues are not addressed appropriately or quickly enough, the baby can be deprived of oxygen and later develop CP. Prenatal complications that can increase the risk of a baby not getting enough oxygen – which can lead to cerebral palsy – may include:
- Oligohydramnios occurs when there is less amniotic fluid (fluid in the womb) than normal. This can lead to umbilical cord compression, which can slow or stop the flow of oxygen and nutrients to the baby. This increases the risk of adverse pregnancy outcomes, including cerebral palsy.
- Maternal 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. There is a risk of transferring the infection to the baby or the baby being born too early (premature birth). Premature birth 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 injury.
- Preeclampsia is high blood pressure that a mother develops during pregnancy. It can constrict or damage the vessels in the placenta that supply oxygen-rich blood to the baby.
- Premature rupture of the membranes (PROM) occurs when a mother’s water breaks before labor starts. PROM can cause many serious issues, including infection, premature birth, and oxygen deprivation. All of these complications increase the risk of brain injury.
- Post-term pregnancy can threaten the baby’s supply of oxygen due to placental deterioration. Towards the end of the pregnancy (around the time the baby is typically born), the placenta starts to deteriorate. Also, the baby may become too big during a post-term pregnancy, 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 been born yet.
Cerebral palsy caused by oxygen deprivation or birth trauma (injury during labor and delivery)
When excessive physical force during birth causes or worsens an injury to a baby, the injury and its complications are referred to as birth trauma. In many cases, a traumatic birth injury during labor and delivery can result in the baby losing oxygen. When a baby is deprived of oxygen, brain injury occurs. A brain injury during birth is a high risk factor for cerebral palsy. The following are all complications that can cause oxygen deprivation or brain injury, which increase the risk for cerebral palsy:
- Macrosomia (when a baby is much larger than normal) and cephalopelvic disproportion (CPD) (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.
- Hypoxic-ischemic encephalopathy (HIE) is a brain injury that occurs when not enough oxygen-rich blood flows to a baby’s brain. HIE can be caused by a variety of different complications and medical errors during birth. If a baby does not get oxygen, a brain injury can occur which leads to cerebral palsy.
- Pitocin or Cytotec are drugs given to mothers to start or speed up labor. Sometimes, these drugs can cause excessively strong or frequent contractions (uterine tachysystole), which can deprive the baby of oxygen-rich blood. These strong, frequent contractions can also put excessive pressure on the baby’s head, which can cause brain trauma. Both oxygen-deprivation and brain trauma can lead to cerebral palsy .
- Umbilical cord problems – which usually occur during labor and delivery – can cause oxygen deprivation at birth and result in cerebral palsy. 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.
Cerebral palsy caused by complications in the perinatal period
The time during and around the time of birth is referred to as the perinatal period. The following perinatal conditions and injuries can increase the risk for injury to the newborn baby and later on cause cerebral palsy:
- Perinatal stroke happens when the blood supply to a part of the baby’s brain is cut off. The risk of pediatric stroke is highest in the perinatal period . Brain injury resulting from a stroke can lead to cerebral palsy.
- Infant brain hemorrhage, or brain bleed, is a type of traumatic birth injury. Depending on the severity and location of the bleeding, serious brain injury can occur.
- Hydrocephalus happens when there is excess fluid in the baby’s brain. This condition can cause head swelling and resultant brain damage.
- Jaundice and kernicterus can cause cerebral palsy and brain damage if ignored or undiagnosed. Jaundice is often an easily treatable condition where too much bilirubin (a byproduct of red blood cells) is built up in the baby’s brain. Bilirubin is a neurotoxin, and when it is not properly treated, it can move into the brain tissue and cause a condition called kernicterus, which damages the brain and can lead to cerebral palsy.
- Neonatal seizures are uncontrolled events caused by abnormal electrical activity in the brain due to brain damage or problems with the brain’s chemistry. 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.
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.
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- Treatments and Therapies for Cerebral Palsy
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