What Causes Cerebral Palsy During Pregnancy?

What Causes Cerebral Palsy During Pregnancy
Risk Factors for Congenital CP – Some things increase the chance that a child will have CP. These are called risk factors. It is important to remember that having a risk factor does not mean that a child will have CP. Some of the risk factors for congenital CP are:

  • Low birthweight―Children who weigh less than 5 1/2 pounds (2,500 grams) at birth, and especially those who weigh less than 3 pounds, 5 ounces (1,500 grams) have a greater chance of having CP. Read article external icon
  • Premature birth―Children who were born before the 37th week of pregnancy, especially if they were born before the 32nd week of pregnancy, have a greater chance of having CP. Intensive care for premature infants has improved a lot over the past several decades. Babies born very early are more likely to live now, but many have medical problems that can put them at risk for CP. Read article external icon
  • Multiple births―Twins, triplets, and other multiple births have a higher risk for CP, especially if a baby’s twin or triplet dies before birth or shortly after birth. Some, but not all of this increased risk is due to the fact that children born from multiple pregnancies often are born early or with low birthweight, or both. Read summary external icon
  • Assisted reproductive technology (ART) infertility treatments―Children born from pregnancies resulting from the use of some infertility treatments have a greater chance of having CP. Most of the increased risk is explained by preterm delivery or multiple births, or both; both preterm delivery and multiple births are increased among children conceived with ART infertility treatments. Read article external icon, Read summary external icon
  • Infections during pregnancy ―Infections can lead to increases in certain proteins called cytokines that circulate in the brain and blood of the baby during pregnancy. Cytokines cause inflammation, which can lead to brain damage in the baby. Fever in the mother during pregnancy or delivery also can cause this problem. Some types of infection that have been linked with CP include viruses such as chickenpox, rubella (german measles), and cytomegalovirus (CMV), and bacterial infections such as infections of the placenta or fetal membranes, or maternal pelvic infections. Read summary external icon, Read article external icon
  • Jaundice and kernicterus ― Jaundice is the yellow color seen in the skin of many newborns. Jaundice happens when a chemical called bilirubin builds up in the baby’s blood. When too much bilirubin builds up in a new baby’s body, the skin and whites of the eyes might look yellow. This yellow coloring is called jaundice. When severe jaundice goes untreated for too long, it can cause a condition called kernicterus. This can cause CP and other conditions. Sometimes, kernicterus results from ABO or Rh blood type difference between the mother and baby. This causes the red blood cells in the baby to break down too fast, resulting in severe jaundice.
  • Medical conditions of the mother―Mothers with thyroid problems, intellectual disability, or seizures have a slightly higher risk of having a child with CP. Read summary external icon
  • Birth complications―Detachment of the placenta, uterine rupture, or problems with the umbilical cord during birth can disrupt oxygen supply to the baby and result in CP. Read summary external icon

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Contents

What makes a fetus high risk for cerebral palsy?

Increased risk – Some things can increase a baby’s risk of being born with cerebral palsy including:

being born prematurely (before the 37th week of pregnancy) – babies born at 32 weeks or earlier are at a particularly high riskhaving a low birthweightbeing part of a multiple birth, such as a twin or tripletthe mother smoking, drinking a lot of alcohol, or taking drugs such as cocaine, during pregnancy

Your doctor may recommend your baby has regular check-ups to look for symptoms of cerebral palsy during the first 2 years of their life if they have an increased risk of developing the condition. Page last reviewed: 13 February 2020 Next review due: 13 February 2023
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What are the chances my baby has cerebral palsy?

About 1 in 345 children has been identified with CP according to estimates from CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network. CP is more common among boys than girls, and more common among black children than among white children.
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Can a mother prevent cerebral palsy?

During Pregnancy –

  • Learn how to have a healthy pregnancy,
  • Get early and regular prenatal care, both for your health and for that of your developing baby.
  • Wash your hands often with soap and water to help reduce the risk of infections that might harm your developing baby.
  • Contact your health care provider if you get sick, have a fever, or have other signs of infection during pregnancy.
  • A flu shot is your best protection against serious illness from the flu. A flu shot can protect pregnant women and their unborn babies, both before and after birth. Flu shots have not been shown to cause harm to pregnant women or their babies.
  • If there is a difference in the blood type or Rh incompatibility between mother and baby it can cause Jaundice and kernicterus, Women should know their blood type and talk to their doctor about ways to prevent problems. Doctors can treat the mother with Rh immune globulin (“Rhogam”) when she is 28 weeks pregnant and again shortly after giving birth to prevent kernicterus from occurring.
  • Talk to your doctor about ways to prevent problems if you are at risk for preterm delivery. Research has shown that taking magnesium sulfate before anticipated early preterm birth reduces the risk of CP among surviving infants. ( 1,2,3,4 )

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Can stress during pregnancy cause cerebral palsy?

Prenatal stress and cerebral palsy: a nationwide cohort study in Denmark – PubMed Objectives: Exposure to prenatal stress may affect neurodevelopment of the fetus, but whether this exposure increases the risk of cerebral palsy (CP) later in life is unknown.

We aimed to examine the association between maternal bereavement during the prenatal time period and CP in childhood. Methods: We conducted a nationwide cohort study by linking information from nationwide registers. All 1,501,894 singletons born in Denmark from 1979 to 2004 were followed up from birth to the end of 2006.

We identified 39,601 children whose mothers lost a close relative (child, spouse, parent, sibling) during pregnancy or up to 1 year before pregnancy and they were classified as the exposed group. The outcome of interest was the diagnosis of CP as registered in the National Hospital Register.

We used Cox Regression to estimate the hazard ratios (HRs). Results: Exposure to maternal bereavement after the loss of a child during the prenatal period was associated with an increased risk of CP among children born preterm without intrauterine growth retardation (HR 2.26, 95% CI, 1.09-3.79) and among children born at term with intrauterine growth retardation (HR 2.01, 95% CI, 1.04-3.89).

Prenatal stress after maternal bereavement by loss of other relatives was not associated with an increased risk of CP. Conclusions: Our data suggest that extremely severe stress in prenatal life could increase the susceptibility for CP among children born preterm or with impaired fetal growth.
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Can cerebral palsy be seen on ultrasound?

Can Cerebral Palsy Be Detected Before Birth? Cerebral palsy cannot be detected before birth. However, if a fetus is in a high-risk category for developing cerebral palsy, performing an ultrasound can detect an abnormality. This allows doctors and parents to start therapy early to help with development.
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Can you tell if your baby will have cerebral palsy in the womb?

How do I know if my child has cerebral palsy? – There is no single test to diagnose cerebral palsy. It can’t be detected during pregnancy. Good medical care during pregnancy and birth can help to reduce the risk that your baby has cerebral palsy. Cerebral palsy might take some time to show itself.

  • muscle stiffness and spasms
  • low muscle tone so that they feel ‘floppy’ when picked up

Other signs to look out for include your baby:

  • being unable to hold up their own head at the right stage
  • being unable to sit up or roll over by 6 months
  • having feeding or swallowing difficulties
  • preferring to use one side of their body

Toddlers with cerebral palsy may not be walking by 12 to 18 months or speaking simple sentences by 2 years of age.
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Can a full term baby have cerebral palsy?

Abstract – More than 50% of infants with cerebral palsy (CP) are born at or near term, with the vast majority having pre- or perinatally acquired CP. While some have a clinical history predictive of CP, such as neonatal encephalopathy or neonatal stroke, others have no readily identifiable risk factors.

  1. Paediatricians are often required to discriminate generalised motor delay from a variety of other diagnoses, including CP.
  2. This paper outlines known causal pathways to CP in term-born infants with a focus on differential diagnosis.
  3. Early and accurate diagnosis is important as it allows prompt access to early intervention during the critical periods of brain development.

A combination of clinical history taking, standard clinical examination, neuroimaging and genetic testing should be started at the time of referral. Attention to the investigation of common comorbidities of CP, including feeding and sleep difficulties, and referral to early intervention are recommended.
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What medical mistake causes cerebral palsy?

When Cerebral Palsy is Caused by Hospital or Doctor Error As a parent of a child with, you know how difficult it can be to cope with the disorder. You probably never imagined that your child would be afflicted with such a devastating disorder and may be wondering what caused it.

Cerebral palsy can affect a child’s ability to perform voluntary movements and can also impact muscle coordination. Some individuals with cerebral palsy have stiff or tight muscles and exaggerated reflexes. Unfortunately, there is no cure for cerebral palsy. Cerebral palsy is the result of brain damage and symptoms usually surface shortly after birth or early in childhood.

Brain damage that leads to cerebral palsy can be caused by infections, long labor and delivery, birth defects, seizures, premature birth, lack of oxygen, low birth weight, bleeding in the brain or genetic conditions. Cerebral palsy has also been linked to birth injuries resulting from errors made by doctors and/or hospitals.

  1. Doctors and hospitals sometimes make mistakes that lead to cerebral palsy.
  2. Some of these catastrophic errors include leaving the infant in the birth canal too long, failure to treat seizures, improper use of forceps or vacuum extraction and failure to detect a prolapsed cord.
  3. When a doctor delays a C-section or doesn’t promptly address complications during labor and delivery, the risk of birth injury increases, which also raises the likelihood of the child developing cerebral palsy.

If your baby has been diagnosed with cerebral palsy and you believe that hospital error or doctor error could have contributed to your child’s disorder, you need to talk with a, The experienced medical malpractice lawyers at Tavss Fletcher can review the details of your case to help you determine the cause of your child’s disorder.
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Who is most at risk for cerebral palsy?

What are the risk factors for cerebral palsy? Some events or medical problems during pregnancy can increase the risk of congenital cerebral palsy. These risk factors include, :

Low birth weight or preterm birth, Infants born preterm (defined as before 37 weeks of pregnancy) and infants who weigh less than 5.5 pounds at birth are at greater risk of cerebral palsy than are early term (defined as 37 weeks to 38 weeks of pregnancy) and full-term (defined as 39 weeks to 40 weeks of pregnancy) infants and those who are heavier at birth. The earlier the birth and the lower the infant’s birthweight, the greater the risk. Multiple gestations, Twins, triplets, and other multiple births are at higher risk of cerebral palsy. The risk is also greater for an infant whose twin or triplet dies before or shortly after birth. Infertility treatments, Infants born from pregnancies resulting from the use of certain infertility treatments are at higher risk for cerebral palsy than are infants born from pregnancies not related to infertility treatments. Much of this increased risk may be due to the fact that infertility treatments are more likely to result in preterm delivery and multiple gestations. Infections during pregnancy, Toxoplasmosis, rubella (German measles), cytomegalovirus, and herpes can infect the womb and placenta, leading to brain damage in the fetus. Fever during pregnancy, Sometimes fever in the mother during pregnancy or delivery can lead to brain damage in the fetus, resulting in cerebral palsy. Blood factor between mother and fetus does not match, Those who have a certain protein found on red blood cells—abbreviated Rh—are Rh positive; those who do not have the protein are Rh negative. If a mother’s Rh factor is different from that of the fetus, her immune system may attack the blood cells of the fetus, including blood cells in the brain, which can lead to brain damage. Exposure to toxic chemicals, If a mother is exposed to a toxic substance, such as high levels of methyl mercury (found in some thermometers and in some seafood), during pregnancy the fetus is at higher risk of cerebral palsy. Maternal medical conditions:

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Abnormal thyroid function Intellectual and developmental disability Too much protein in the urine Seizures

Complicated labor and delivery, Infant heart or breathing problems during labor and delivery and immediately after birth increase the risk of cerebral palsy. Jaundice (pronounced JAWN-dis ). Jaundice, which causes an infant’s skin, eyes, and mouth to turn a yellowish color, can be a sign that the liver is not working normally. Jaundice occurs when a substance called bilirubin (pronounced BIL-uh-roo-bin ) builds up faster than the liver can clear it from the body. This condition is common and is usually not serious. However, in cases of severe, untreated jaundice, the excess bilirubin can damage the brain and cause cerebral palsy. Seizures, Infants who have seizures are more likely to be diagnosed with cerebral palsy later in childhood.

Some risk factors for acquired cerebral palsy are :

Infancy, Infants are at greater risk than older children for an event that causes brain damage. Preterm or low birthweight, Children born preterm or at a low birthweight have a higher risk for acquired cerebral palsy. Not getting certain vaccinations, Childhood vaccinations can prevent brain infections that can cause cerebral palsy. Injury, Not taking certain safety precautions for infants or lack of adult supervision can lead to injury that can cause cerebral palsy.

: What are the risk factors for cerebral palsy?
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How do you know if your baby is special needs in the womb?

– Many types of birth defects can be diagnosed during pregnancy. A healthcare professional can use prenatal ultrasounds to help them diagnose certain birth defects in utero. More in-depth screening options, such as blood tests and amniocentesis (taking a sample of the amniotic fluid), may also be done.

These tests are usually offered to women who have higher-risk pregnancies due to family history, advanced maternal age, or other known factors. Prenatal tests can help determine whether the mother has an infection or other condition that’s harmful to the baby. A physical examination and hearing test may also help the doctor diagnose birth defects after the baby is born.

A blood test called the newborn screen can help doctors diagnose some birth defects shortly after birth, before symptoms occur. It’s important to know that prenatal screening doesn’t always find defects when they’re present. A screening test can also falsely identify defects.
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Can you give birth naturally with cerebral palsy?

Men With Cerebral Palsy – Just as with women, men cannot pass down cerebral palsy to their children, as it’s not an inherited disorder. A man with cerebral palsy has the same chances of having a baby with cerebral palsy that a man without the disorder.
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Does folic acid prevent cerebral palsy?

Begin taking folic acid – Studies show that regular doses of folic acids reduce the risk of prematurity – a significant cause of Cerebral Palsy – by 70 percent. The importance of maintaining a prenatal vitamins regimen is advised.
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Can C section cause cerebral palsy?

C-Section Injury Possibilities for Infants – Despite the fact that these delivery methods have become safer through new advances in medical technology and knowledge, there is still much potential for complications and injuries that arise from the use of cesarean delivery.

These problems can arise in either the child or the mother and can be unavoidable or caused by the result of medical negligence or error. Many of the complications of a C-section delivery to the mother are the result of problems with the anesthesia, or more commonly, the failure to order a medically necessary c-section in sufficient time.

C-section injury problems relating to anesthesia can arise when the mother has allergic reactions to the medication or when the wrong dosage, either too much or too little, is given to her. Complications from anesthesia problems might include:

Low blood pressure Internal bleeding Headaches Blood clots

Other complications that might affect the mother outside of medicinal concerns include many of the complications generally associated with any surgical procedure including infections and hemorrhaging. Just as there are many potential issues that could harm the mother during a C-section delivery, there is also much harm that could affect the newborn infant during this process.

Breathing problems in the infant are of the utmost concern. In fact, breathing problems occur more often in infants after a C-section than after a vaginal birth. Because of this, it is important to monitor the baby after delivery in order to watch for signs that breathing issues are occurring. Potentially fatal, breathing issues in infants during c-section deliveries is a commonly cited cause of cerebral palsy developing in the infant.

Similarly, to the mother, infants can be negatively affected by the anesthesia and medications taken by the mother. Other problems can arise if the C-section is performed later than is recommended, which in normal circumstances, would be the result of the failure of medical professionals to recognize fetal distress as it relates to breathing and other issues.

This can occur because a doctor failed to get the patient into surgery quick enough, the need for a C-section occurred because of a complication during labor, a surgical room was not readily available, or any other host of reasons, of which are outside the normal standard of care in c-section and c-section injury treatment.

If the C-section is delayed too long, the likelihood of complications increase and can include brain damage caused by lack of oxygen, physical deformities, and even death. Sources:

http://www.mayoclinic.org/tests-procedures/c-section/basics/risks/prc-20014571 http://americanpregnancy.org/labor-and-birth/cesarean-risks/

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What is the life expectancy of a female with cerebral palsy?

Mild cerebral palsy life expectancy – An individual with mild cerebral palsy will likely have a similar life expectancy as an individual who does not have the condition. An article written by Dr. Ananya Mandal, a clinical pharmacologist from the Government Medical College in West Bengal, shows that a two year-old child with mild cerebral palsy has a 99% chance of living to 20 years old.
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Can poor nutrition during pregnancy cause cerebral palsy?

Quick Answer Cerebral palsy can be caused by a variety of factors, including physical injury, bacterial or viral infection or poor maternal nutrition during pregnancy. It is primarily associated with damage to the brain that impedes normal development. Cerebral palsy can also be caused by doctors who use excessive force during delivery that leads to brain damage. Get a Free Case Review
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What foods help fetus brain development?

Introduction What Causes Cerebral Palsy During Pregnancy What is happening in the brain during pregnancy? In-utero is a critical brain developmental period once gene–environment interactions influence the maternal-placental-foetal triads, resulting in both short- and long-term outcomes on brain health, Many factors influence offspring neuro functional and structural outcomes, but nutrition has particular importance,

  1. All nutrients are essential to neuroplasticity, however the role of glucose, fats (including long-chain polyunsaturated fatty acids), protein, iron, zinc, iodine, copper, folate and choline have been highlighted in several studies.
  2. Ey Risk Factors Key risk factors during this stage include nutritional and other lifestyle considerations, such as smoking, as well as socio-economic status and levels of stress.

Nutritional Risk Factors Folate and B12 Insufficiency Although there is growing evidence on the role of preconception nutrition for improved birth outcomes and the benefits of periconceptional folic acid for preventing neural tube defects, less is known about the impact on intellectual functioning in early childhood and beyond and more research is required.

  1. Maternal pre-pregnancy BMI has, however, been negatively associated with children’s cognitive performance, even after adjusting for socio-demographic confounders and children’s BMI, and this relationship appears to become stronger as children get older,
  2. Iodine Deficiency Furthermore, a positive association has also been identified between iodine status before conception and child IQ, supporting its link to poorer cognitive function reported in other studies,

However, unexpectedly there was a lack of association to measures of executive function. Although deficiencies are always best avoided, further data are required to establish the public health importance of low preconception iodine status. Overall Nutritional Status Additional recent data shows that weekly preconception supplementation of multiple micronutrients improved certain domains of intellectual functioning at age 6 to 7 years compared with folic acid alone,

  1. The impact of supplementation on child intellectual functioning was also magnified among children whose mothers consumed supplements at least 6 months before conception.
  2. Moreover, this effect was greatest among children born into families with the lowest household socioeconomic status.
  3. These findings suggest the scope for preconception micronutrient interventions to have long-term benefits for cognition, particularly for these members of the community.

Maternal Gut Health Maternal gut microbiota has been associated with abnormalities in the brain function and behaviour of offspring—often in response to factors like infection, high- fat diet or stress during pregnancy. Interactions between gut microbiota and intestinal mucosa cells influence the immunological tolerance and production of pro- and anti-inflammatory substances (e.g., cytokines).

Previous studies in mice have observed that changes in the gut microbiota, may alter levels of brain-inflammatory factors in the cortex and hippocampus, interfering in the brain plasticity, Imbalances in the Ratio of Omega 3: Omega 6 Animal research reveals that a maternal diets rich in omega-6 fats (and low in omega-3) impairs the neuronal layer formation in the offspring’s neocortex, and also provides compelling evidence that these diets can have long- lasting effects on the offspring’s mental state and abnormal levels of anxiety in adulthood.

More recent research has indicated that when pregnant females consume diets high in polyunsaturated omega-6 fatty acids, the produced excess of endocannabinoids overloads the corresponding cannabinoid receptors in the foetal brain. The consequence of this is that healthy brain development is impaired by disrupting and limiting neuronal signalling,

In line with this, evidence shows that a good balance of omega-6 and omega-3 fatty acids is known to improve the development of brain functions. Omega-3 supplementation during either pregnancy or infancy has actually been found to improve child neurodevelopment, indicating the importance of sufficient polyunsaturated fatty acid intake by pregnant women and young children,

Lifestyle Risk Factors Smoking tobacco Intrauterine tobacco exposure, including passive smoking, are linked with several negative nicotine, carbon monoxide and other toxin-related effects, The mechanisms by which prenatal exposures influence early neurodevelopment and neurobehavioural dysfunction are numerous, highly interrelated and not completely understood,

However, it is well established that the negative effects of tobacco are dose and duration-responded, particularly disrupting the neurological route of neurotransmitters, acetylcholine and dopamine, Continued exposure to smoking toxins throughout pregnancy may influence offspring neurodevelopment, coursing with foetal developmental brain vulnerability, increased risk of neuropsychiatric disease, such as autism, schizophrenia, depression, anxiety, attention and hyperactivity disorders,

Moreover, evidence has shown that nicotine intake during the second trimester of pregnancy affects the dopaminergic neurological system, making the foetal brain more susceptible to nicotine and developing ADHD symptoms not just in a foetus but, persisting later into adolescence,

  • Alcohol consumption Alcohol is teratogenic to the foetus and can be harmful to babies’ brains even in small amounts.
  • Higher foetal sensitivity to the alcohol effects has been recognised at a very early pregnancy stage (between the second and tenth week of pregnancy), a period when many women do not know yet to be pregnant.

Pregnant women’s alcohol consumption may cause the Foetal Alcohol Syndrome, which is a disease entity characterised by neurobehavioral abnormalities, several brain damages and body structure changes, Stress During Pregnancy Higher maternal cortisol concentration (one of the primary biomarkers of physiological stress) in early gestation was associated with higher prevalence of child affective problems, while pregnancy anxiety at 19 weeks gestation was associated with several brain anatomic change,

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Evidence also shows that maternal pre-pregnancy BMI, but not weight gain during pregnancy, is associated with a 2.8-fold increase in the prevalence of ADHD among children of obese, compared to those of non-obese mothers, Taken together, the findings support the notion that pre-conceptional and prenatal conditions may impact child brain development, with significant offspring brain alterations being associated with variation in environmental conditions during gestation.

Barriers/challenges to achieving optimal neurological health & strategies Recognising maternal nutrient needs and how genetic and lifestyle factors impact metabolism, is the best way to empower actions to improve nutritional approaches to prenatal care,

There remain many challenges in understanding the complex interplay of maternal-placental-foetal conditions and injury on early neurodevelopment, as well as potential overlapping mechanisms of brain harm, However, antepartum, peripartum, neonatal, and early childhood have been already been indicated to be highly important sensitive windows and integrated stages to promote brain health,

As children grow, deficits in socio-emotional function and intellectual abilities become increasingly apparents, especially regarding social judgement, antisocial behaviour, interpersonal skills, and academic achievements, Early stimuli such as post and prenatal maternal nutrition may increase the risk of adverse health outcomes, either physical or mental, in later life,

  1. Due to foetal neuroplasticity even a small increase in developmental risk associated with prenatal exposure may be sufficient to move significant numbers of children into the developmentally delayed range of functioning,
  2. Despite being recognised as extremely relevant to proper foetal neurodevelopment, the low adherence to nutritional recommendations is a global issue,

Multiple sociocultural factors such as income, education, cultural traditions, food availability and affordability, individual beliefs and preferences, social, geographical, and environmental aspects influence maternal choices both, post conception and during gestation,

  • Moreover, social-economic stressors along with environmental stressors exacerbates pre-existing disparities and maternal health conditions,
  • Optimal nutrition during pregnancy requires a multi-faceted approach including effective strategies to determine nutrient status, address key nutrient gaps, and gain a deeper understanding of maternal nutrient interactions on foetal and childhood brain development,

Nutritional Interventions Table 1 below lists some key nutrients for preconception and pregnancy, with their functions and food sources.

Nutrient Functions Sources
EPA & DHA Essential nutrients for normal brain development as they are integral structural components of neurological systems. DHA is also important to retinal development and eye health, Helps to develop the baby’s brain, including memory, learning, behaviour, neural repair, vision and emotions Oily fish (like mackerel, sardines, salmon and tuna) or vegan algae supplement (plant-based)
Vitamin A Helps to strengthen the immune systems against infectious diseases such as measles and diarrhoea. Also, essential for retina development (vision and preventing blindness), however, too much can result in malformation. Carrots, squash, Sweet Potato; Dark Green Leafy Vegetables, lettuce.
Vitamin C Mild deficiencies of Vitamin C in pregnant mothers could stunt the foetal hippocampus by 10-15% Orange, lemon, strawberry, kiwi, guava, acerola cherries, lychees, papaya, bell peppers, broccoli, parsley, brussel sprouts, kale
Vitamin B6 Vitamin B6 is the main cofactor of biological reactions. Vitamin B6 deficits imposed during pregnancy and/or early postnatal periods in rats have been shown to interfere with the normal development of at least four regions of brain: neocortex, caudate/putamen, cerebellum, and the medulla oblongata. Beef, poultry, fish, spinach, avocado, banana, sunflower seed, sweet potato.
Folic Acid (Vitamin B9) May help to prevent spinal cord defects and brain damage. Acts as a cofactor in numerous enzyme pathways in the brain. Important throughout the foetal period, first enhancing neuronal proliferation and migration from 6–24 weeks’ PCA and then regional brain differentiation in the third trimester. Green leafy vegetables, citrus fruits, bananas, and beans
Vitamin B12 There is evidence of positive association between maternal vitamin B12 status during pregnancy and offspring neurocognitive performance at 2 and 9 years of age Meats, poultry, pork, ham, fish (salmon), eggs and dairy- milk
Vitamin D Pivotal in early immune development and early skeletal development. Although not completely established, prenatal hypovitaminosis D is linked with increased risk of neurodevelopmental disorders, poor cognitive and motor development and schizophrenia. Most vitamin D is dermo-produced through sun exposure, but it can be found in fatty fish (tuna and salmon), fortified food (milk, orange juice, soy milk, cheese), egg yolks, cod liver oil and wild mushrooms.
Vitamin K Important in the nervous system, and research increasingly demonstrates its anti-inflammatory activity and protective effect against oxidative stress. Though not yet definitive, evidence of a direct correlation between vitamin K levels and cognitive performance has been found. Citrus fruits, potatoes, and dark green leafy vegetables.
Zinc It is second in trace metal abundance in the central nervous system. Important for neural tube formation Governs stem cell proliferation and neurogenesis in the central nervous system during foetal brain development. Zinc is also needed to support the senses of taste and smell. The highest concentrations are found in the choroid layer of the retina.and in the hippocampus. Clinical studies and preclinical models suggest that zinc sufficiency between 24 and 40 weeks’ PCA is important for the proper development and function of the hippocampus, cerebellum and autonomic nervous systems. Red meat, poultry items, oysters, cashew nuts and almonds.
Iron Iron deficiency anaemia is the most common nutritional deficiency worldwide, and is related to pre-eclampsia, preterm labour and premature rupture of membranes. Maternal deficiency is linked with the behavioural and neural development of changes in white matter myelination, striatal monoamine metabolism and hippocampal function. Meat, beans, nuts, dried fruit, wholegrains, fortified breakfast cereals, soybean, most dark-green leafy vegetables.
Iodine Essential for the production of thyroid hormones in the mother’s body, and also normal development of foetal brain. Iodine deficiency leads to a state of hypothyroidism, which results in lower brain weight and DNA content, reduced neuronal dendritic arborization and synaptogenesis and hypomyelination, Mild maternal iodine deficiency may have adverse effects on foetal cognitive development. Research shows children whose mothers had low dietary iodine intakes (from food) during pregnancy were more likely to experience symptoms of impaired brain development at aged three e.g. language delay, behaviour problems, and reduced fine motor skills. Seaweed (nori, kelp, kombu, wakame); fish, shellfish, dairy (milk, yoghurt, cheese), eggs, liver, chicken
Choline Choline is crucial for optimal brain development, with early life deficits causing long-term impacts on brain function. It is also utilised in retinal development and lack of adequate amounts could adversely impact eye health. Choline also alters timing of neuronal differentiation in the septum and the hippocampus, two brain regions known to be involved in learning and memory. Supplementing the diet of pregnant mothers with choline has even been found to reduce the damaging effects of alcohol consumption on their unborn children’s brain development ( Bottom et al., 2020 ). Results from a tightly controlled randomised feeding study have also suggested that when pregnant mothers consume sufficient amounts of the nutrient choline, their offspring gain enduring cognitive benefits, Eggs, poultry, and dairy
Selenium Selenium deficiency is linked with recurrent pregnancy loss, pre-eclampsia and intrauterine growth restriction. Cord serum selenium concentration is directly correlated with the infant head circumference, Seafood, eggs, poultry, kidney, liver, cereals, nuts, garlic, and radish
Copper Important to the connective tissues, iron metabolism, production of melatonin, heart function, immune system function and development of the central nervous system. Copper is a vital cofactor of antioxidant enzymes and is involved in removing pregnancy oxidative stress. Oxidative stress may lead to poor pregnancy outcomes such as pre-eclampsia, foetal growth restriction, and miscarriage. Evidence has approved the effective role of copper in neurobehavioral and neuro-cognitive development during the last two third of pregnancy. Shellfish, kidney, liver, wholegrains, nut, beans, dark leafy greens, cocoa, dried fruits,

Table 1: Key Nutrients for Preconception and Pregnancy Researched by: Dr Natalia Medeiros and Hazel de Maeijer References Abel, M.H., Caspersen, I.H., Meltzer, H.M., Haugen, M., Brandlistuen, R.E., Aase, H., Alexander, J., Torheim, L.E. and Brantsæter, A.L., 2017.

Suboptimal maternal iodine intake is associated with impaired child neurodevelopment at 3 years of age in the Norwegian Mother and Child Cohort Study. The Journal of Nutrition, 147 (7), 1314-1324. Alisi, L., Cao, R., De Angelis, C., Cafolla, A., Caramia, F., Cartocci, G., Librando, A. and Fiorelli, M., 2019.

The relationships between vitamin K and cognition: a review of current evidence. Frontiers in Neurology, 10, p.239. Amgalan, A., Andescavage, N., and Limperopoulos, C., 2021. Prenatal origins of neuropsychiatric diseases. Acta Paediatrica, 110 (6), 1741-1749.

Asindi, A.A., and Torty, C., 2022. Zinc function in childhood brain. Nigerian Journal of Paediatrics, 49 (1), 14-16. Babushkina, E.A., Belokopytova, L.V., Grachev, A.M., Meko, D.M. and Vaganov, E.A., 2017. Variation of the hydrological regime of Bele-Shira closed basin in Southern Siberia and its reflection in the radial growth of Larix sibirica.

Regional Environmental Change, 17 (6), 1725-1737. Basatemur, E., Gardiner, J., Williams, C., Melhuish, E., Barnes, J. and Sutcliffe, A., 2013. Maternal prepregnancy BMI and child cognition: a longitudinal cohort study. Pediatrics, 131 (1), 56-63. Berglundh, S., Vollrath, M., Brantsæter, A.L., Brandlistuen, R., Solé-Navais, P., Jacobsson, B.

and Sengpiel, V., 2021. Maternal caffeine intake during pregnancy and child neurodevelopment up to eight years of age—Results from the Norwegian Mother, Father and Child Cohort Study. European Journal of Nutrition, 60 (2), 791-805. Bilbo, S.D. and Schwarz, J.M., 2009. Early-life programming of later-life brain and behavior: a critical role for the immune system.

Frontiers in Behavioral Neuroscience, 3, 14. Bispham, J., Gopalakrishnan, G.S., Dandrea, J., Wilson, V., Budge, H., Keisler, D.H., and Symonds, M.E., 2003. Maternal endocrine adaptation throughout pregnancy to nutritional manipulation: consequences for maternal plasma leptin and cortisol and the programming of fetal adipose tissue development.

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How can I prevent cerebral palsy during birth?

Can cerebral palsy be prevented? – Cerebral palsy can’t be prevented or cured. However, some public health measures help to prevent cerebral palsy. These include:

  • car seatbelts
  • pool fencing
  • rubella vaccinations

There are also a number of interventions for high-risk infants. These can reduce the risk or severity of cerebral palsy. Three examples are:

  1. A course of steroids given to mothers who are at risk of a preterm birth. Steroids can reduce the risk of preterm babies having cerebral palsy.
  2. Magnesium sulphate given to mothers who are at high risk of very preterm birth can prevent cerebral palsy.

Cooling newborn babies who have suffered a brain injury due to a lack of oxygen at birth. This can reduce the impact of the brain injury.
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Can folic acid prevent cerebral palsy?

Begin taking folic acid – Studies show that regular doses of folic acids reduce the risk of prematurity – a significant cause of Cerebral Palsy – by 70 percent. The importance of maintaining a prenatal vitamins regimen is advised.
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What foods prevent cerebral palsy?

Cerebral Palsy Dietary Needs – Cerebral palsy describes a spectrum of motor impairments at varying severities. Therefore, nutritional needs will vary amongst individuals with cerebral palsy. Factors that must be taken into consideration include:

Severity of motor impairments. Generally, individuals with milder motor impairments are more physically active and require more energy intake. Oral motor impairments, If cerebral palsy affects the muscles around the mouth, individuals may struggle to chew and swallow their food. If your child has oral motor impairments, consider using a blender or food processor to break down their food and make it easier to digest. Premature birth, Premature birth is a common cause of cerebral palsy. Infants born prematurely are often smaller, which should be taken into consideration when accessing their dietary needs. About 85% of children born prematurely catch up to their developing peers during the first 2 years of life. Co-occurring complications, Some children with cerebral palsy have gastrointestinal reflux disease, which can cause stomach acid to irritate the esophagus and cause heartburn. Greasy, spicy, or acidic foods can trigger acid reflux and should be avoided.

Individuals with severe oral motor impairments may need to use a feeding tube. While many parents may be opposed to a feeding tube, it’s essential to prioritize your child’s nutrition as they grow. Your child may not have to solely rely on the feeding tube.
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Can cerebral palsy be detected in the womb?

Cerebral palsy cannot be detected before birth. However, if a fetus is in a high-risk category for developing cerebral palsy, performing an ultrasound can detect an abnormality. This allows doctors and parents to start therapy early to help with development.
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