Complications of Birth

Complications that increase a child’s chance of developing cerebral palsy can arise during pregnancy or during labor and delivery. Formerly, it was believed a complicated birth (in combination with asphyxia) was the sole cause of cerebral palsy. Now it’s known that complicated birth in combination with asphyxia accounts only for a relatively small percentage of cerebral palsy cases, less than 10%.

Research indicates that events occurring during fetal development can also cause complicated delivery.

APGAR Score

Newborns are tested after birth and assigned an Apgar score. An Apgar score is a method to quickly summarize an infant’s health based on respiration, muscle tone, reflexes, color, and heart. A low Apgar score is a significant risk factor for cerebral palsy. Newborns are evaluated at one minute and five minutes after birth, and at subsequent intervals, if necessary. Five criteria are scored on a scale of 0 to 2 (for the one minute and five minute readings). Both scores are added together. A score of:

  • 7 to 10 is considered normal
  • 4 to 6 low
  • 0 to 3 is critical

The five criteria are:

  • A: Appearance – skin color and complexion
  • P: Pulse – heart rate
  • G: Grimace Response – crying or grimacing when stimulated
  • A: Activity – muscle tone where flexed arms and legs resist straightening
  • R: Respiration – quality of breathing, based on rate and effort

Other birth complications heighten the odds of asphyxia occurring, or increase probability that a child will develop cerebral palsy. These complications include but are not limited to:

  • Abnormal presentation or breech birth in which the baby enters the birth canal in a manner other than head first
  • Emergency cesarean sections (C-sections)
  • Prolonged second stage of delivery (from the point when the cervix is dilated to 10 cm through delivery)
  • Premature separation of the placenta from the mother’s uterus
  • Premature rupture of the membranes in which the amniotic sac ruptures prior to labor

Cerebral Palsy Risk Factors

There are ten common risk factors. To learn more about them, click one of the following:

The presence of one or more risk factors does not ensure a child will develop cerebral palsy; it means chances are higher than if that risk factor was not present. Likewise, the absence of risk factors does not ensure that a child will not develop cerebral palsy. Risk factors merely identify possible cause for concern. Avoiding risk factors will help prevent a child from developing cerebral palsy; any exposure to risk factors prior to conception and during pregnancy should be discussed with a doctor in order to effectively treat and manage risk. This list is not meant to be all-inclusive; other risk factors may contribute to the development of cerebral palsy, as well.