Cerebral palsy risk factors: international experience

Abstract

This review article aims to outline several risk factors for the Cerebral Palsy (CP) development worldwide. CP is the most prevalent disabling condition in children that imposes a significant socio-economical responsibility on the system of the health care. Despite a solid body of extant research, the exact etiology of CP remains unknown. There are several risk factors that may be triggering CP development at pre-, intra- and postnatal periods, particularly, gestational age, birth weight, mother's health, placental abnormalities, thrombophillia, asphyxia, brain ischemia and multiple pregnancies. According to extant literature, the majority of CP cases develop within antenatal period in high-income countries. Contrastingly, in developing countries, there is a slightly higher proportion of a postnatally acquired CP cases linked to post-infectious brain damage following meningitis, septicaemia, as well as other conditions, such as malaria. However, these studies were of a small size and not case-controlled or population-based, which significantly curtails the results and underestimating the real picture. With very small number of survivors of early preterm, common risk factors identified to be the maternal rhesus allergenic immunization and birth asphyxia, or hereditary diseases, such as dehydrogenase of glucose-6-phosphate (G6PD) deficiency and encephalopathy of subsequent bilirubin. According to standardized data from international surveillance programs, important risk factors are strongly associated with CP development in most countries.