What are the Risk Factors for Cerebral Palsy?
There are a number of factors that can increase the chances a child will develop cerebral palsy. Understanding these risk factors and the different ways women can mitigate the risks can improve a mother’s chance of delivering a baby without this condition.
Risk Factors for a Cerebral Palsy Diagnosis
Most medical experts believe cerebral palsy has no one cause. Instead, it usually occurs due to a sequence of events or circumstances.
According to the Centers for Disease Control and Prevention (CDC), babies satisfying one or more of the following criteria are at greater risk of having cerebral palsy:
- Low birth weight. A low birth weight is less than 5.5 pounds at birth. Babies weighing less than 3 pounds, 5 ounces have a greater risk.
- Premature birth. Babies born before 37 weeks are considered premature. The risk increases for babies born before 32 weeks.
- From a multiple birth. Cerebral palsy risk increases if one of the multiples passes away during childbirth or shortly after.
- From assisted reproductive technology
- Not vaccinated
In addition, expectant mothers might have a higher risk of delivering a baby with cerebral palsy if they satisfy one or more of these criteria:
- An infection during pregnancy, such as rubella, chickenpox or cytomegalovirus
- Thyroid problems
- Intellectual disabilities
- Complications during labor, such as a detached placenta, ruptured uterus, or problems with the umbilical cord
Remember, however, that satisfying one or more of the criteria above does not necessarily guarantee the child will have cerebral palsy.
While cerebral palsy is not preventable, women expecting or planning to have children can take some steps to minimize the risks of their children developing the condition. Those steps are:
- Maintain good health
- Wash hands regularly with soap and water
- Start regular prenatal care early in pregnancy
- Seek medical attention when health issues arise
- Get vaccinated for potential harmful diseases, including chickenpox, rubella and influenza
- Transfer one embryo at a time during assistive reproductive technology treatments
- Know blood type, by performing an Rh factor test. Women with Rh-negative blood can receive Rh immune globulin treatments early in pregnancy and within 72 hours of giving birth to limit risk of incompatibility
- Take magnesium sulfate if you anticipate a preterm delivery
Birth asphyxia is a common risk factor for developing cerebral palsy. Women can receive birth asphyxia treatment during labor if the baby’s oxygen delivery is compromised. This can be determined through intrapartum fetal monitoring techniques, including measuring lactate concentrations and using intrapartum cardiotocography.
Concentrated lactate associated with fetal distress was higher in instrumental delivery. This finding points to the importance of having a natural birth, if possible.
Parents can take the following measures to minimize the risk of their new baby developing cerebral palsy:
- Monitor the baby for jaundice
- Vaccinate the child against infections that can cause encephalitis and meningitis
- Use an age-appropriate car seat
- Use window guards and safety gates to prevent falls
- Supervise children around baths, pools and bodies of water
- Ensure the child always wears a helmet when riding a bike, skating and enjoying other potentially dangerous activities
- Refrain from hitting, throwing, shaking or otherwise harming your child
Monitoring Development of at Risk Children
Parents should monitor the development of children at greatest risk of developing cerebral palsy carefully. The earlier the diagnosis, the earlier parents can practice early intervention.
Early intervention helps children with cerebral palsy between birth and three years of age, the time at which they’re rapidly learning and developing. It might be more difficult for children with cerebral palsy to learn the skills taught during early intervention at a later stage.
Babies under six months might exhibit the following signs of cerebral palsy:
- Head lags when picking up the baby lying on his or her back
- Body feels very stiff or floppy
- Back and neck overextend while being cradled, as if to push away
- Legs stiffen or cross when the baby is picked up
A baby over six months with cerebral palsy might have the following signs:
- Asymmetrical tonic neck reflex. When a young baby turns its head to the side, the arm on the same side stretches out while the other arm flexes at the elbow behind the head. This is known as asymmetrical tonic neck reflex, which usually disappears between six and seven months of age.
- The baby reaches out with one hand while keeping the other in a fist.
Further signs indicate a baby over 10 months of age might have cerebral palsy, including:
- Baby appears lopsided while crawling.
- Baby moves on buttocks or knees rather than crawling on all fours.
The American Academy of Pediatrics encourages parents who note any of these signs to discuss their concerns with their pediatrician. You might be referred to a developmental pediatrician or pediatric neurologist.
Learning more about cerebral palsy is an excellent way to minimize your risks of having a child with the condition. If your child does develop cerebral palsy, your research will also alert you to the signs so you can seek early intervention.