Low Vitality Scores Linked with Cerebral Palsy

Ian C. Langtree - Writer/Editor for Disabled World (DW)
Published: 2011/04/17 - Updated: 2022/04/20
Topic: Cerebral Palsy (CP) - Publications List

Page Content: Synopsis - Introduction - Main

Synopsis: Study reveals how vitality scores at birth are associated with the development of cerebral palsy in infants. Cerebral palsy is a disorder that impairs the part of the brain that controls a person's muscle coordination and movement. Lack of oxygen to the brain during birth is one of the causes of cerebral palsy.

Introduction

A study has found that newborns with low vitality scores at birth have an increased incidence of cerebral palsy, a serious type of birth injury caused by lack of oxygen to the brain during labor and delivery.

Main Item

A recent study published in the British Medical Journal found that low vitality scores at birth are associated with the development of cerebral palsy in infants. Cerebral palsy is a disorder that impairs the part of the brain that controls a person's muscle coordination and movement. Lack of oxygen to the brain during birth is one of the causes of cerebral palsy.

After birth, all babies are given a vitality, or Apgar score. Apgar's scores are scaled from zero to 10, with babies receiving seven to 10 considered within the normal range, four to six considered fairly low and three or less critically low. Apgar's scores are based on five criteria: breathing, complexion, muscle tone, pulse rate and reaction when stimulated.

The study found that children with an Apgar score of three or less had a 100 times greater incidence of developing cerebral palsy than children scoring 10. However, the study also found that even among babies receiving a four or lower vitality score, 90% of them did not develop cerebral palsy.

Based on their findings, the researchers believe that cerebral palsy is closely related to factors that reduce an infant's vitality and that low Apgar scores may indicate the infant's brain was impaired during the mother's pregnancy or delivery.

Erb's Palsy and Other Birth Injuries

Cerebral palsy is just one type of birth injury. Another potentially serious birth injury is Erb's palsy. Erb's palsy happens when there is a stretch injury to the brachial plexus, a network of nerves located near the baby's neck that control movement down the arm and into the hands and fingers. On average, one to two babies out of every 1000 born in the US have Erb's palsy.

Erb's palsy injuries often are the result of difficult deliveries. This can happen when the baby is in breech position and in cases when the baby is large, making labor and delivery more difficult and take longer. Erb's palsy also can happen in cases when the baby must be delivered quickly and the treating physician has to use force to remove the baby, either manually or thanks to a vacuum or forceps. In these cases, the baby's neck can be stretched - and with it the brachial plexus - leading to the development of Erb's palsy.

Babies with Erb's palsy may still be able to move their arms or fingers, so a child could be affected by the disorder but still have some function in the arm and hand. The child's doctor will look for weakness in one of the arms and also may order X-rays and other diagnostic tests to determine if the baby has suffered the nerve injury. Parents who notice that their child is favoring one arm more than the other or not using one of the arms at all should notify their pediatricians.

Most babies with Erb's palsy recover from the injury and regain movement and feeling. Other babies, however, will not and may suffer permanent loss of function in the arm. In addition to cerebral palsy and Erb's palsy, other types of birth injuries include:

• Broken bones.
• Bruising and lacerations.
• Subconjunctival hemorrhage (eye bleeding).
• Cephalohematoma (bleeding underneath the cranial bones).
• Caput succedaneum (bruising and swelling of the baby's scalp).
• Hypoxic Ischemic Encephalopathy (i.e., when the baby's brain does not get enough oxygen and blood - can lead to cerebral palsy, mental retardation and epilepsy).

During labor and delivery, the treating physician and support staff are responsible for monitoring the mother and baby's vital signs, including their heart rates and oxygen levels for signs of distress. When these signs are not properly monitored or when the doctor falls to take appropriate action in response to distress indicators, like performing a timely C-section, a birth injury can occur. While many birth injuries are minor, some are severe and can result in life-long impairments to the child or even death.

Author Credentials: Ian was born and grew up in Australia. Since then, he has traveled and lived in numerous locations and currently resides in Montreal, Canada. Ian is the founder, a writer, and editor in chief for Disabled World. Ian believes in the Social Model of Disability, a belief developed by disabled people in the 1970s. The social model changes the focus away from people's impairments and towards removing barriers that disabled people face daily. To learn more about Ian's background, expertise, and achievements, check out his bio.