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Reproductive & Child Health News

Damage That Causes Cerebral Palsy May Occur Before Birth
November 22, 1999

Experts have long thought that depriving the fetus of oxygen during childbirth is the main cause of cerebral palsy, but an extensive review of medical literature by an international task force of physicians and other health professionals reveals otherwise.

According to a study by researchers at the University of Adelaide Women's and Children's Hospital in Australia, which was published recently in "The British Medical Journal," cerebral palsy is most often caused by events that occur during the development of the fetus or after the infant is born. These events include metabolic disorders in the fetus, growth abnormalities, problems with the fetus' immune system, blood coagulation disorders, and infections.

The International Cerebral Palsy Task Force noted that the normal, healthy fetus has many mechanisms to protect it against small episodes of oxygen deprivation. It takes a major event like a ruptured uterus, tearing away of the placenta, umbilical cord problems, or fetal hemorrhage to cause serious damage to the fetus' brain. When oxygen deprivation does occur, it causes only about one in four or less cases of only two types of cerebral palsy: spastic quadraplegia and dyskinetic.

Cerebral palsy is generally not diagnosed until months or years after a child is born, and it is usually impossible to determine what happened in the brain before birth. The task force emphasized the importance of monitoring the fetal heartbeat during labor and that the initial assessment of the newborn, the Apgar score, does not necessarily predict the child's neurological health.

The purpose of this study was to develop guidelines for diagnosing the causes of cerebral palsy. Such guidelines are important because they may influence future research into the causes and prevention of cerebral palsy, what counselors tell their patients, and how experts testify in court.


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