Research scientists have
examined thousands of expectant mothers, followed them
through childbirth, and monitored their children's early
neurological development. As a result, they have uncovered
certain characteristics, called risk factors, that increase
the possibility that a child will later be diagnosed with
cerebral palsy:
- Breech presentation.
Babies with cerebral palsy are more likely to present feet
first, instead of head first, at the beginning of labor.
- Complicated labor and
delivery. Vascular or respiratory problems of the baby
during labor and delivery may sometimes be the first sign
that a baby has suffered brain damage or that a baby's
brain has not developed normally. Such complications can
cause permanent brain damage.
- Low Apgar score. The
Apgar score (named for anesthesiologist Virginia Apgar) is
a numbered rating that reflects a newborn's condition. To
determine an Apgar score, doctors periodically check the
baby's heart rate, breathing, muscle tone, reflexes, and
skin color in the first minutes after birth. They then
assign points; the higher the score, the more normal the
baby's condition. A low score at 10-20 minutes after
delivery is often considered an important sign of
potential problems.
- Low birthweight and
premature birth. The risk of cerebral palsy is higher
among babies who weigh less than 2500 grams (5 lbs., 7 1/2
oz.) at birth and among babies who are born less than 37
weeks into pregnancy. This risk increases as birthweight
falls.
- Multiple births. Twins,
triplets, and other multiple births are linked to an
increased risk of cerebral palsy.
- Nervous system
malformations. Some babies born with cerebral palsy have
visible signs of nervous system malformation, such as an
abnormally small head (microcephaly). This suggests that
problems occurred in the development of the nervous system
while the baby was in the womb.
- Maternal bleeding or
severe proteinuria late in pregnancy. Vaginal bleeding
during the sixth to ninth months of pregnancy and severe
proteinuria (the presence of excess proteins in the urine)
are linked to a higher risk of having a baby with cerebral
palsy.
- Maternal
hyperthyroidism, mental retardation, or seizures. Mothers
with any of these conditions are slightly more likely to
have a child with cerebral palsy.
- Seizures in the newborn.
An infant who has seizures faces a higher risk of being
diagnosed, later in childhood, with cerebral palsy.
Knowing these warning signs
helps doctors keep a close eye on children who face a higher
risk for long-term problems in the nervous system. However,
parents should not become too alarmed if their child has one
or more of these factors. Most such children do not have and
do not develop cerebral palsy.