Infant Respiratory Distress Syndrome May Increase Risk of Cerebral Palsy in Premature Babies

Babies who are born prematurely and who have infant respiratory distress syndrome (IRDS) have a higher risk of developing cerebral palsy (CP), according to a study conducted by researchers in Denmark.

According to the authors of the study “Respiratory distress syndrome in moderately late and late preterm infants and risk of cerebral palsy: a population-based cohort study,” published in the British Medical Journal, recognizing the increased risk of cerebral palsy could be helpful in planning follow-up and intervention strategies in children born prematurely.

The team of researchers led by Dr. Henrik Toft Sørensen of Aarhus University Hospital in Denmark used nationwide medical registries to identify all infants born during 32 to 36 full gestational weeks in Denmark from 1997 to 2007, with and without IRDS.

The scientists followed the infants from birth until the diagnosis of CP, emigration, death, or end of the follow-up period, which was in 2014. The team identified 39,420 babies born prematurely, and a total of 2,255 (5.7 percent) were diagnosed with IRDS.

Researchers found that 1.9 percent of the premature babies who had IRDS later developed CP, while this ratio was only 0.5 percent in premature babies who did not have IRDS. The risk of cerebral palsy in premature babies with IRDS increased further if they were also diagnosed with intracerebral hemorrhage (ICH), a condition where blood suddenly bursts into the brain tissue, or intraventricular hemorrhage (IVH), where bleeding occurs in the fluid-filled areas (ventricles) inside the brain.

“To our knowledge, this is the first study to specifically determine the association between infant respiratory distress syndrome and cerebral palsy,” the authors wrote in their report.

But they added: “Even though this study is one of the largest examining a potential association between infant respiratory distress syndrome and cerebral palsy, it still does not clarify the specific causes leading to increased risk of cerebral palsy.”

Cerebral palsy is the most common cause of severe disabilities in early childhood. The most important risk factor for CP is premature birth, observed in around 30 percent of all children with cerebral palsy. ICH and IVH also contribute to the development of CP.

IRDS is caused by a lack of surfactant in the lungs, and is seen in premature babies. This leads to the collapse of the lungs, decreased gas exchange, and oxygen deprivation in the brain. ICH and IVH are complications associated with IRDS.

Previous studies have shown that IRDS is also associated with an increased risk of neurodevelopmental problems. It can negatively affect the ability to think and perform well in school, as well as lead to attention-deficit hyperactivity disorder (ADHD).