Potential Signs of Cerebral Palsy in Newborns
Cerebral palsy (CP) affects motor skills, movement, and muscle tone while hindering the body from moving in a purposeful and coordinated way. It may also affect other body functions involving muscles and motor skills like talking, bowel and bladder control, eating, and breathing.
Cerebral palsy signs newborn babies may exhibit are often the result of brain damage happening before or during childbirth.
What Are the Signs of Cerebral Palsy?
Each cerebral palsy case presents unique signs and symptoms, making it difficult to identify diagnosis generalities. While a cerebral palsy diagnosis can happen in the earlier stages of a child’s life, sometimes even within weeks of their birth, it typically requires months of careful observations to identify possible symptoms of cerebral palsy. This makes diagnosing CP in newborns difficult. The Apgar score is one way medical professionals can identify babies at risk for cerebral palsy.
What Is the Apgar Score?
The Apgar score is a test newborn babies are given shortly after birth. This test checks muscle tone, heart rate, and other areas to determine if emergency or other additional medical care may be required. Five things are utilized in checking a baby’s health, with each being scored on a scale of 0-2:
- Appearance or skin color
- Pulse or heart rate
- Grimace response or reflexes
- Activity or muscle tone
- Respiration or breathing rate and effort
Medical professionals add the scores for each of these factors together to achieve an Apgar score between 0 and 10, with ten being the best possible score.
The Apgar test is generally given two times. First at one minute after childbirth and then again five minutes after childbirth. If medical professionals have concerns about the newborn’s condition, the test might be administered again.
Lower Apgar Scores and Cerebral Palsy
Slightly lower scores, especially one-minute scores, are common in babies born after a high-risk pregnancy, prematurely, via c-section, or after complicated labor or delivery. Lower scores don’t always mean a baby is unhealthy. It may just mean they require additional medical care, such as oxygen to help them breathe better or suctioning of their airways.
The score is given again at five minutes after birth. If a low one-minute Apgar score hasn’t improved or other concerns have presented themselves, the baby will continue to be closely monitored for signs of birth injuries or symptoms that may point to other conditions, including cerebral palsy.
How Birth Injuries Happen
Damage to a developing brain happening before, during, and after childbirth can lead to cerebral palsy. A birth injury refers to any damage occurring during labor and delivery, or shortly after childbirth. Many fetal brain injuries occur before a baby is born, but small percentages of injuries happen in the delivery room.
Brain Damage and Cerebral Palsy
Birth injuries resulting in CP in newborns can come in various forms. There are four primary kinds of brain damage resulting from birth injuries. Understanding these kinds of brain damage and the effects they have on the brain can help explain how they may cause cerebral palsy.
Hypoxic-Ischemic Encephalopathy (HIE)
Hypoxic-ischemic encephalopathy refers to brain damage resulting from decreased oxygen and blood levels to the brain. HIE is the leading preventable birth injury that affects the brain and may lead to CP in newborns. It destroys brain tissue and cells, predominantly in the motor cortex of newborns who develop CP. HIE can happen during pregnancy or childbirth. If it occurs during pregnancy, it can result in another kind of brain damage: periventricular leukomalacia.
Periventricular Leukomalacia (PVL)
Periventricular leukomalacia is the death of the brain’s white matter and the subsequent loss of tissue. PVL specifically happens when there is a lack of blood flow to the periventricular section of the brain where you find white matter. White matter is made up of nerve fibers that relay signals for motor function and allow the brain to learn.
Intracranial hemorrhage occurs when there is bleeding in the brain, with fetal stroke being the most common reason for this happening. This is most commonly found in premature babies. Damaged or blocked blood vessels in a newborn’s brain can result in a stroke and hemorrhaging. Maternal infections such as pelvic inflammatory disease, high blood pressure, and complications with the placenta can all result in intracranial hemorrhaging.
Anything inhibiting the healthy development of a fetal or infant’s brain can result in abnormal development of the motor control center. Cerebral dysgenesis refers to this abnormal development. This typically happens during pregnancy while the brain develops. Direct injury to a baby’s head during or after childbirth, along with infections that can mutate genes responsible for motor function development, can also result in cerebral dysgenesis.
While a CP diagnosis in newborns isn’t common, there are cerebral palsy signs newborn babies may display that will signal to medical professionals the need for additional monitoring. If you feel your child’s cerebral palsy was the result of medical negligence, complete our online form today and let the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, LLC evaluate your case in a free, no-obligation consultation.
Trish Fletcher, MS, BSN, CRNP, NNP-BC, ALNC
Neonatal Nurse Practitioner | Birth Injury Legal Nurse Consultant
Tricia is a dedicated, focused, Birth Injury Legal Nurse Consultant and Neonatal Nurse Practitioner with more than 25 years of experience. Her strong clinical and critical thinking skills, paired with expertise caring for neonates in a Level III Neonatal Intensive Care Unit (NICU), ensures meticulous medical records review. READ FULL BIO