Epidemiology-- Who does CP affect, and why?

This week I want to let Jamaul Thomas and his family have the first word.



According to the Centers for Disease Control and Prevention (CDC), cerebral palsy (CP) is the name for a number of disorders that all affect a person's balance, posture, and ability to move. The CDC estimates that in the U.S., an average of 1 in 323 children have a CP disorder-- making CP responsible for the most common childhood motor disabilities.

In the U.S., the CDC states that CP is more common among Black children than Latino, Asian, or White children. It is also more common in boys than in girls. Children with CP also commonly have another disorder-- the most common co-occurring disorders are epilepsy and autism spectrum disorder.

Cerebral palsy is linked to the lack of oxygen in the brain of a fetus, newborn, or infant-- but there are many different ways that oxygen can be blocked. Some children with CP were affected by a traumatic birth, in which there was a problem with their umbilical cord or with blood flow to the placenta. Others suffered strokes or hemorrhages as newborns.

The more we know about the root causes of a disorder, the easier it is to decrease the number of people it affects. With a group of disorders like CP, there are so many potential causes that its occurrence is difficult to control-- but there are some things that women can do to increase their fetus' access to oxygen, and to decrease their child's risks of experiencing CP.

In a study from 1996 to 2008, researchers found that women were significantly more likely to deliver a baby with CP if they had had, during pregnancy, vaginal infections (especially untreated infections) or fever, or had smoked 10 or more cigarettes per day. 81,066 mothers and their newborns participated. By accessing prenatal care, getting treatment for infections and illnesses, and cutting down on or stopping smoking, women can decrease their risk of giving birth to a child with CP. However, these services are much harder to access for some women than for others-- for example, women living in rural areas, women unable to get time off of work for prenatal visits, and women with traumatic experiences from dealing with the healthcare system may not get the care, education, or support they need to make these changes.

There is still a great deal of research to be done on the causes and risk factors of cerebral palsy-- and there are many situations in which a child's CP was unavoidable by either the parents or by healthcare providers. It is clear, however, that providing easy access to quality prenatal care and education for all women is a good place to start in reducing the high rates, and discrepancies, in children with CP.


Sources

Boyle, CA et al. Trends in the prevalence of developmental disabilities in US children, 1997-2008. Pediatrics, 2011.

Streja, E et al. Congenital cerebral palsy and prenatal exposure to self-reported maternal infections, fever, or smoking. American Journal of Obstetric and Gynecology. October 2013; 209 (4): 332.