Cerebral palsy (CP) is the name given to a group of neurological disorders characterized by problems in muscle movement, coordination, and posture.
CP is caused by damage to the brain while it is still developing. For some patients, this occurs before birth (congenital CP), while for others, it occurs after birth (acquired CP).
Many insults can damage a developing brain. A number are summarized below.
Oxygen deprivation
It was once thought that most or all cases of CP were caused by oxygen deprivation during birth; for example, a result of the umbilical cord wrapping around the baby’s neck and cutting off oxygen supply. Such asphyxia is no longer thought to be responsible for the vast majority of cases, although it can contribute to some.
Complications during pregnancy can also affect the oxygen reaching the fetus in the womb. These include detachment of the placenta (sometimes called placental abruption), and uterine rupture, which is more common in people who have previously had abdominal surgery or a cesarean section (C-section).
Infections
Infections during pregnancy or in early childhood can affect the developing brain and cause CP. Infections lead to the production of immune signaling molecules called cytokines, which cause inflammation. Inflammation in the mother’s body can damage the brain of the developing baby. Maternal infections that have been linked to CP include chickenpox, rubella, cytomegalovirus, and pelvic infection.
Infections such as meningitis or encephalitis during infancy can also cause brain damage and lead to CP. This is why carefully adhering to infant vaccinations, on the schedule recommended by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), is considered extremely important.
Injury
Physical damage to the brain, such as head injuries caused by car accidents or abuse, can cause CP. Even accidental falls (for example, from a crib or changing table) can be severe enough to affect the developing brain.
Blood flow problems
Blood flow to the brain is very important. Disruptions to this flow, caused by incidents such as a stroke or bleeding caused by blood clotting problems, can cause CP. Health conditions that might contribute to the development of stroke or clots in the brain’s blood vessels can include blood vessels that did not form properly during development, heart defects, and sickle cell disease.
Other risk factors
Most cases of CP have no single causative factor but rather a combination of factors, which act together to exacerbate injury or damage to the brain. These are summarized below.
Low birth weight
Babies who are small for their gestational age, or are born prematurely, are more likely to develop CP than are infants born within the normal weight range and at full term (typically, 37 to 40 weeks).
Blood type incompatibility
A mismatch in the blood type or RH factor between the mother and a developing child can cause the mother’s immune system to attack the baby. In most cases, this causes mild jaundice that is treatable after birth. But blood type mismatches can become increasingly dangerous in subsequent pregnancies, for both the mother and child. These blood type mismatches are more common in children who later develop CP.
Multiple births
Children who are twins, triplets or part of multiple births are more likely to develop CP. However, if one twin or triplet develops CP, it is very rare for the other(s) to also develop the disease. It is common for twins, triplets or babies in higher-number births to be born premature and underweight, which can also contribute to this outcome.
Assistive reproductive technology (ART)
Children conceived through ART, such as in vitro fertilization may be more likely to develop CP. This may be due to the fact that ART increases the likelihood of multiple fetuses, premature birth, and low birth weight, all of which are also risk factors.
Maternal illness
Some medical conditions in the mother make CP in the child more likely. These include thyroid problems, intellectual disability, and seizures.
Genetic factors
It is possible that genetic factors contribute to the development of CP. Although no causative genes have been identified, it is likely that some genetic characteristics contribute to susceptibility for CP.
Last updated: Feb. 24, 2020
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