Closing in on risk factors for cerebral palsy and infant death

Karin B. Nelson, M.D., scientist emeritus at the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health, and her colleagues from the University of Sydney, the University of Western Australia and Sydney Adventist Hospital in Australia examined the degree to which four specific risk factors contributed to cerebral palsy and young infant death. The risk factors were asphyxial birth events (incidences during labor and delivery that had the potential to interfere with oxygen getting to the newborn's brain), inflammation (signs of infection), birth defects, and poor fetal growth (low birth weight plus some other factors related to expected size).

Cerebral palsy is a group of neurological disorders that appear in early childhood and affect body movement and muscle coordination. Movement problems associated with cerebral palsy include dyskinesia (uncontrollable writhing or jerky movements) and spastic quadriplegia (severe stiffness in the limbs).

In this study, published in Obstetrics & Gynecology, the researchers compared the medical records of children with cerebral palsy and infants who died within 1 month of birth with the records of healthy children to identify how often the risk factors occurred in the groups.

Among the cerebral palsy and infant death cases, birth defects and poor fetal growth were the most common risk factors. Birth defects and/or poor fetal growth were seen in almost half of the cerebral palsy cases. In addition, out of the four risk factors, only birth defects and/or poor fetal growth predicted dyskinesia or quadriplegia.

Many studies looking into the causes of cerebral palsy have concentrated on asphyxial birth events. However, the current findings indicate that poor fetal growth and birth defects may greatly contribute to cerebral palsy and infant death, suggesting that research should focus more on those specific risk factors.