NEW INSIGHTS INTO CAUSES OF CEREBRAL PALSY

For a long time it was thought that interruption of oxygen supply to the fetus was the major cause of cerebral palsy (CP), and also an important cause of other developmental disorders in children. Evidence available in mid-2006 indicates that asphyxial birth is a minor cause of CP and not a substantial contributor to other disability in children without CP. Importantly, efforts to prevent asphyxia-related CP have not resulted in reduction in the frequency of CP in any birth weight group, but have been associated with an increased rate of obstetrical intervention including surgical delivery during active labor.

Research in the past two decades has identified more common contributors to CP in term and near-term infants, notably perinatal arterial ischemic stroke and exposure in utero to infection or inflammation. Complications of multiple birth also contribute to CP risk. There is emerging evidence of genetic contributions to risk of CP. This presentation will discuss this recent evidence and its implications regarding the interacting roles of coagulation, inflammation, and disordered vasomotor regulation in the pathobiology of CP, and the placenta as intermediary and indicator, with focus on advances in understanding of CP etiology in term and near-term infants.