"Cerebral" refers to the brain and "palsy" indicates paralysis, defining cerebral palsy as damage to an infant's delicate neurological system. The March of Dimes reports 12.8 percent of births in the United States are premature, occurring prior to 37 weeks gestation. Babies born prematurely are eight times more likely to be diagnosed with cerebral palsy than their full-term peers.
Decreased Oxygen Supply
Infant respiratory distress syndrome, or RDS, is a complication of prematurity that can lead to cerebral palsy in severe cases. Lung development is not complete until between 34 and 37 weeks. During this time the lungs begin to produce surfactant, a fluid that coats the lung tissue for efficient air exchange. Babies lacking surfactant have impaired lung function and are unable to deliver adequate oxygen to the bloodstream and into the brain. Cell death occurs in organs including the brain when oxygen levels are too low.
Brain Bleed
Infants born before 30 weeks gestation are at risk for intraventricular hemorrhage, or IVH. This is due to the fragility of the blood vessels in the brain prior to that stage in development. The incidence and severity increase when a baby's body has been exposed to increased stress, such as respiratory distress or high blood pressure. Bleeding within the enclosed space of the skull places pressure on the brain tissue and results in damage relative to the extent of the bleeding.
Infection
The British Medical Journal reports a link between cerebral palsy and exposure to viral infections both before and shortly after birth. Infection and inflammation contribute to the incidence of preterm delivery, and once the baby is born they increase the odds of issues including periventricular leukomalacia, or PVL. Nervous tissue around the ventricles, or fluid-filled spaces in the brain, experience decreased blood flow, resulting in the death of scattered small areas of brain tissue. This area is particularly susceptible to damage before 32 weeks.
Jaundice
Preemies are more susceptible to developing jaundice than full-term infants, and are likely to be more affected by it. When the liver is not able to adequately handle the demands placed upon it, a substance called bilirubin, a byproduct of breaking down red blood cells, accumulates in the body. Excessive levels of bilirubin are toxic to brain tissue.
Injury
In rare instances trauma to the head during labor or delivery contributes to the development of cerebral palsy. Premature rupture of the amniotic sac may send the mother into spontaneous labor and complicates the medical plan of care, occasionally requiring emergency measures to complete delivery. This may rarely lead to unintentional trauma to the premature infant's head.
References
- March of Dimes: Premature Birth
- Penn State Children's Hospital: Infant Respiratory Distress Syndrome
- National Libraray of Medicine and the National Institutes of Health: Intraventricular Hemorrhage of the Newborn
- Healthline: Jaundice in the Premature Baby
- "The New York Times" Health Guide: Periventricular Leukomalacia
