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CAUSES OF CEREBRAL PALSY.

Until recently, it had been well accepted that cerebral palsy (CP) results from perinatal asphyxia. This important report shows that cerebral palsy in the full-term infant is usually caused by prenatal intrauterine problems, such as congenital malformations, rather than by perinatal asphyxia.

Naeye and associates analyzed data from the Collaborative Perinatal Study, focussing on 43,437 full-term babies who were followed until they reached 7 years of age. One hundred fifty children within this group had CP. Asphyxia was the likely cause in only 9 children (6 percent), while congenital disorders were the most common cause, accounting for 36 cases. Among central nervous system malformations, hydrocephalus caused eight cases, meningomyelocele five cases and encephalocele three cases; CNS infections caused four cases. Cardiac malformations were the most frequent non-CNS cause of CP, resulting in 18 cases. No cause could be found for 60 percent of the 116 children with nonquadriplegic CP, whereas most of the 34 children with quadriplegic CP had a discernible cause.

The authors conclude that current obstetrical and pediatric state-of-the-art practices cannot prevent most cases of CP in term babies because the CNS damage occurs long before labor and delivery. Litigators should take note that CP most often is not caused by perinatal asphyxia.

— RAD

Published in Journal Watch General Medicine October 17, 1989

Citation(s):

Naeye RL et al. Origins of cerebral palsy. Am J Dis Child 1989 Oct 143 1154-1161.

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