A study on the risks of cerebral palsy depending on race, ethnicity and socioeconomic status published recently in the journal Pediatrics provides one more reason for women to stay in school and ensure they receive proper prenatal care.
The study concluded that African-American infants were 29 percent more likely to have cerebral palsy than white infants caused primarily by their risk of low birth weight. The researchers from various organizations in California stressed the likelihood that better educational attainment and prenatal care might be the best strategies for reducing the incidence of cerebral palsy.
Donna Roberts, executive director of the Cerebral Palsy Association of Greater Indiana, said she’s not surprised by the study’s link between low birth weight and cerebral palsy.
“That’s the leading cause when we know there’s a cause,” she said. “The irony is that for most of us, we don’t know.”
However, in her 45 years working with cerebral palsy, Roberts said, she never before heard of a specific connection between being African-American and the risk of cerebral palsy. But she agrees there may be cultural and economic factors that limit prenatal care, increasing the risk.
According to the March of Dimes, up to three children per 1,000 have cerebral palsy.
The National Institute of Neurological Disorders and Strokes’ latest estimate for the lifetime cost of treating a child with cerebral palsy stands at more than $921,000, but the number increases dramatically almost every year.
Other factors that may cause cerebral palsy include birth trauma and bacterial infection in the mother close to labor and delivery.
Many African-American mothers face a triple threat of delivering a pre-term baby because they are African-American, they are younger than 17 and they are of low socioeconomic status. Each of these factors increases the likelihood they won’t receive the proper prenatal care.
Each of these factors also contributes to infant mortality. Marion County for decades has struggled to reduce the double-digit percentage of infant mortality among African-American babies. The Marion County Health Department (MCHD) reports in 2009, the most recent year for which figures are available, the infant mortality rate was 20.6 percent, up several percentage points over previous years and about twice the rate for both white and Hispanic babies.
Low birth weight and very low birth weight held steady at about 14.4 percent and 3.5 percent respectively, according to MCHD figures. The department reports the rate of prematurity at 15.2 percent, about five percentage points higher than Hispanics and four percentage points higher than white babies.
More than one-third of African-American women did not seek prenatal care in the first trimester, according to the MCHD.
The March of Dimes recommends that women not wait until they are pregnant but seek a preconception visit, especially if they are in a high-risk group.
The risk of developing cerebral palsy in a premature baby may be reduced through treatment with magnesium sulfate, according to a study published in 2008 in the New England Journal of Medicine.
Weighing the risks
The March of Dimes lists the following medical conditions, which may contribute to a premature delivery of a low birth weight baby at risk of cerebral palsy:
n Infections (including urinary tract, vaginal, sexually transmitted and other infections)
• High blood pressure and preeclampsia
• Diabetes
• Clotting disorders (thrombophilia)
• Being underweight before pregnancy
• Obesity
• Less than 18 months between pregnancies
