Do concepts of causes and prevention of cerebral palsy require revision?

Article Abstract:

Published criteria for judging whether cerebral palsy is caused during labor by lack of oxygen to the baby may need to be reexamined. In 1992, the American College of Obstetricians and Gynecologists (ACOG) published guidelines which list four criteria by which practitioners may link lack of oxygen to the baby at during labor to cerebral palsy. A researcher analyzed the medical literature and four cases of children with cerebral palsy whose births were complicated and compared the information to the four criteria. The first criteria, a low umbilical blood pH level indicating acidemia, gave confusing results when compared with observations and the literature. Apgar scores, the second criteria, may not correctly predict cerebral palsy unless they stay below four for over 20 minutes. However, the third criteria, seizures of the newborn, appeared predictive of cerebral palsy. The last ACOG criteria, multiorgan dysfunction, was not evident in the four cases. New research should be done to detect and prevent injuries before birth that can lead to cerebral palsy.

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Selection of Neonates for Neuroprotective Therapies

Article Abstract:

Efforts to protect and support the brain and central nervous system in some high-risk newborn infants is unlikely to prevent cerebral palsy (CP). Researchers reviewed 84 cases of children that ultimately developed this form of paralysis, and compared them to 366 healthy children. Among the children who developed CP, 20 required a ventilator, five had acidic blood, seven had an infection or an infected mother, eight had a bleeding disorder, and nine were born of mothers with a complicated pregnancy. These conditions may have caused the neurological damage leading to CP, and neuroprotective care after birth would likely not have prevented the condition.

United States, Care and treatment

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Fractured clavicle and Erb's palsy unrelated to birth trauma

Article Abstract:

Some cases of fractured clavicles or Erb's palsy after birth may not be associated with any known risk factors, and might not be preventable. Erb's palsy is nerve damage distinguished by limited arm movements. Fifty-one infants with Erb's palsy and 236 with clavicle fractures were investigated. Difficult delivery of the shoulder called shoulder dystocia, and abnormally heavy infant weight were associated with these traumas. However, more than half of the fractures and 25% of the cases of Erb's palsy had no known risk factors or apparent cause for these birth injuries.

Injuries, Risk factors, Fractures (Injuries), Fractures, Paralysis, Clavicle

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