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The many causes of newborn brain injuries

A report is shedding new light on brain injuries in newborn babies, and changing the prevailing and longstanding belief about how those injuries occur. Although oxygen deprivation during labor and delivery does cause brain damage in newborns, it is not the primary cause, as has long been believed. Rather, other prenatal and maternal factors were found to be responsible for a significant majority of cerebral palsy and other brain injuries.

According to the report, which is titled Neonatal Encephalopathy and Neurologic Outcome, approximately three out of every 1,000 full-term babies born in the U.S. suffer brain injuries. Only half of those injuries are linked to insufficient oxygen during the labor and delivery process. 

Further, in many of those instances, an earlier issue – which was the real cause of the brain injury – caused the effects of the oxygen deprivation to be exaggerated, making it appear that the lack of oxygen was to blame for the injury when that was not really the case.

Those other, earlier-occurring brain injury causes include major bleeding during pregnancy, fetal membrane infections, placental abnormalities, prenatal stroke, maternal health issues and genetic factors.

Although oxygen deprivation is not responsible for as many birth injuries as was previously believed, it is still a significant risk in delivery rooms in New York and across the country. The report details several factors which should be considered together to determine the cause of a brain injury. If Apgar scores are low, major organs have failed, acid levels in the umbilical artery are high, and an M.R.I. shows a certain injury pattern, it is likely that the brain injury was caused by insufficient oxygen during labor and delivery.  If not, doctors will likely need to perform additional testing to determine the cause and course of treatment for the injury.

Source: The New York Times, "Hurt Before the Birth," Jane E. Brody, May 5, 2014

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