Therapeutic hypothermia — induced cooling of the body for a short time — in newborn babies deprived of oxygen at or around the time of their birth is effective in preventing cerebral palsy, according to a review study.
Likewise, caffeine given to preterm newborns as they were being weaned from machine-assisted breathing was also helpful, while those treated in the first week or so of life with corticosteroids to avoid chronic lung disease were more likely to develop cerebral palsy, its researchers report.
Cerebral palsy is an umbrella term for a group of diseases that affect movement and posture. It is the most common physical disability of childhood, usually due to events that occur before, during, or after birth that cause injury to a developing brain.
While there is no single cause known to lead to cerebral palsy, many risk factors are associated with its development. In particular, injury during the neonatal period, which lasts from birth to one month of life, is linked to high rates of cerebral palsy, as is preterm or premature birth, defined as birth before 37 weeks of pregnancy.
Other risk factors during the neonatal period include loss of oxygen for a time; brain injury; a stroke or seizure; blood vessel disease; diseases of the airways and lungs, requiring prolonged mechanical assistance for breathing; certain infections; and jaundice.
Due to these many risk factors, different treatment approaches are necessary to lower the risk of a child developing cerebral palsy.
Researchers did an extensive review of published scientific studies — 43 Cochrane reviews — to evaluate the effectiveness of interventions during the neonatal period related to cerebral palsy.
Reviews included babies who may have had a lack of oxygen at or around the time of birth, preterm or at low-birthweight babies, and those at risk of brain injury.
Therapeutic hypothermia was found to be effective in preventing cerebral palsy across seven different studies involving 881 children. Newborns who experienced a lack of oxygen and underwent induced hypothermia were less likely to develop cerebral palsy than those given standard care.
Another effective intervention —the results of one trial involving 644 children — was stimulants like caffeine given while weaning newborns from a breathing machine. Preterm babies who received methylxanthine treatment (caffeine) as their reliance on machine-assisted breathing was slowly ended were less likely to develop cerebral palsy than those given a placebo.
Lastly, 12 trials involving 1,452 children spotlighted an ineffective treatment and one with potential to do harm: preterm newborns treated at less than 8 days of age with corticosteroids to prevent lung disease were more likely to develop cerebral palsy than those who received a placebo.
Overall, the researchers were able to identify “one intervention that was effective in preventing cerebral palsy (induced hypothermia), one that was possibly effective for preventing cerebral palsy (caffeine), one that appeared to cause harm (corticosteroids).”
“This overview … can be used by researchers, funding bodies, policy makers, clinicians, and consumers to aid decision-making and evidence translation,” they concluded.