What Causes Cerebral Palsy?

What causes cerebral palsy?

Cerebral palsy is caused by damage to, or abnormal development of, the parts of the brain that control movement, and that damage can occur before birth, around the time of delivery, or in early infancy. In many children the exact cause is never pinned down with certainty, but research has mapped the major pathways well enough to group them by timing.

Understanding the timing matters for two reasons. Medically, it guides how doctors interpret a child’s history. Legally, it is the single most important question: a cause rooted in an unpreventable event during pregnancy is very different from one rooted in a preventable failure during labor.

Prenatal causes (before labor)

Events during pregnancy account for the largest share of cerebral palsy. These include:

• Infections during pregnancy: maternal infections such as rubella, cytomegalovirus (CMV), toxoplasmosis, and chorioamnionitis can trigger inflammation that injures the fetal brain.
• Problems with placental blood flow: when the placenta does not deliver enough oxygen and nutrients, areas of the developing brain can be damaged.
• Fetal stroke: a blood clot or bleeding in the fetal brain interrupts blood supply.
• Abnormal brain development: genetic differences, gene mutations, or disruptions in how the brain forms during pregnancy.
• Maternal medical conditions, such as thyroid problems, seizures, or clotting disorders.

Most of these are not preventable and are not anyone’s fault. That is a central, well-established fact about cerebral palsy.

Perinatal causes (around the time of birth)

A smaller but important share of cases arises from injuries at or near delivery. This is the window where medical care has the most direct influence on outcome, and where preventable failures, when they occur, are found.

• Hypoxic-ischemic encephalopathy (HIE): brain injury from oxygen deprivation during labor and delivery. Causes include umbilical cord compression or prolapse, placental abruption, uterine rupture, and prolonged or obstructed labor. When fetal distress is visible on the monitor and not acted on, or a necessary cesarean is delayed, HIE may be preventable. See our full HIE guide.
• Kernicterus: brain injury from severe, untreated newborn jaundice. Because jaundice is easily measured and treated, kernicterus is considered almost always preventable; it classically produces the dyskinetic (athetoid) form of CP. See kernicterus.
• Serious newborn infection: sepsis or meningitis acquired around birth, especially when signs are missed or antibiotics are delayed.
• Severe hypoglycemia: dangerously low blood sugar in a newborn that is not detected and corrected.

Postnatal causes (after birth)

A small percentage of cerebral palsy is acquired in the weeks and months after birth, from causes such as:

• Bacterial meningitis or viral encephalitis
• Severe head injury (including abusive head trauma)
• Near-drowning or other events causing oxygen loss
• Complications of severe prematurity, such as brain bleeds (intraventricular hemorrhage)

Risk factors that raise the odds

A risk factor is not a cause. Many children with these risk factors are perfectly healthy, and many children with CP had none of them.

When a cause involves medical negligence

Medical negligence does not act as a separate cause of cerebral palsy. It is a failure to prevent or properly manage one of the causes above. The recurring failure points that birth injury attorneys and medical experts look for include:

• Fetal heart-rate distress that was visible on monitoring but not recognized or acted on
• A medically necessary cesarean section that was delayed
• Misuse of forceps or vacuum extraction
• Failure to diagnose and treat maternal or newborn infection
• Failure to measure and treat dangerous newborn jaundice
• Failure to detect and correct severe low blood sugar
• Improper newborn resuscitation

The bottom line

Most cerebral palsy is not caused by medical malpractice. Major research reviews, including guidance from the American College of Obstetricians and Gynecologists, have concluded that only a limited fraction of CP is attributable to events during labor and delivery, and that many cases begin with problems in pregnancy that current medicine cannot prevent. Any evaluation that promises a payout before reading the records is not being straight with you.

At the same time, the minority of cases that do stem from preventable failures are real, and the children affected face the same lifetime of costs. That is why the records review, not a slogan, is the right starting point.

What this means for a legal claim

A cerebral palsy claim succeeds only if the records show that care fell below the accepted standard and that the failure caused the brain injury. The timing evidence (when fetal distress appeared, how long until delivery, what the newborn’s blood gases and bilirubin showed) is what connects a cause to a potential breach of the standard of care. If you believe your child’s CP may be birth-injury-related, see whether a claim is possible on our can you sue for cerebral palsy page, and note that filing deadlines vary by state on our statute of limitations guide.

Where a case is handled depends on where the care occurred: Banville Law attorneys are licensed in New York and Washington, D.C.; The Weitz Firm attorneys are licensed in Pennsylvania and New Jersey; elsewhere, the alliance connects families with its vetted network of local birth injury attorneys.

Frequently asked questions

What is the most common cause of cerebral palsy?

There is no single most common cause. Collectively, prenatal events (problems during pregnancy such as infection, impaired placental blood flow, fetal stroke, and abnormal brain development) account for the largest share, especially in babies born prematurely.

Can lack of oxygen at birth cause cerebral palsy?

Yes. Oxygen deprivation around delivery causes hypoxic-ischemic encephalopathy (HIE), which is one recognized cause of cerebral palsy. Whether it was preventable depends on how fetal distress was monitored and managed.

Is cerebral palsy ever caused by jaundice?

Yes. Severe, untreated newborn jaundice can cause kernicterus, which classically leads to the dyskinetic (athetoid) form of cerebral palsy. Because jaundice is easily measured and treated, this cause is considered largely preventable.

Could my child’s cerebral palsy have been prevented?

Sometimes, but not always. Only a review of the actual delivery and newborn records can tell whether a preventable failure occurred. A responsible evaluation will say so plainly when the care met the standard.

Sources

This page is for general education and is not medical advice. Medical facts above are drawn from the cited primary sources; legal statements reflect the reviewing attorneys’ professional experience. Always consult your child’s physician about medical concerns.