Causes and high risk factors of pediatric cerebral palsy

       In general, all causes that can cause ischemia, hypoxia, poisoning and developmental abnormalities in fetal and neonatal brain tissue can cause brain damage and lead to cerebral palsy, while the direct causes are brain injury and brain developmental defects. There are many clinical risk factors that can easily cause brain injury, call it high-risk factors, which can be divided into: 1. Before birth: about 20%-30% (1), genetic factors: diseases related to cerebral palsy include spastic-dance disease, familial spastic paraplegia, demyelinating disease, Friedreich’s ataxia, etc. Most of them are caused by gene mutation.  (2) Infections in early pregnancy: rubella virus, cytomegalovirus, toxoplasmosis, syphilis and other infections can cause malformation of brain development in the first six months, and destructive lesions of the brain parenchyma after six months, resulting in hydrocephalus, enlarged ventricles, microcephaly and other changes.  (3), physical and chemical factors: radiation exposure during pregnancy, organic mercury, carbon monoxide poisoning, lead poisoning, etc. (4), fetal ischemia and hypoxia: severe maternal anemia, malnutrition, pre-eclampsia, gestational toxicity, multiple births, placenta, amniotic fluid and other abnormalities 2, at birth: about 70%-80%, prolonged labor, placenta praevia, placenta abruptio, umbilical cord around the neck, umbilical cord prolapse, breech position, fetal head attraction, intrauterine hypoxia, etc.  3, after birth: about 10-20%, low weight immature babies (<2500 grams) or huge babies (>4000 grams), premature birth (26-31 weeks) or overdue birth () 42 weeks), neonatal asphyxia, neonatal spasms, pathological jaundice, neonatal pneumonia, cyanotic episodes, intracranial hemorrhage, anemia, severe malnutrition, etc. The authors counted 242 cases of high risk factors for children with cerebral palsy in 89, and the results were: neonatal asphyxia, severe jaundice, and premature underdevelopment as the three major causes In recent years, domestic and foreign research on the etiology of cerebral palsy has concluded that abnormal development in the early embryonic period is an important cause of prematurity, low birth weight and perinatal ischemia and hypoxia. In 1975, Hapbers reported that 46% of cerebral palsy cases born in Sweden between 1954 and 1970 had prenatal causes (including 21% of unknown causes), 48% had perinatal causes (within seven days before and after delivery), and 6% had postnatal causes. It is evident that advances in clinical obstetrical techniques and improvements in neonatal medical care have inevitably led to an increase in the proportion of prenatal risk factors for cerebral palsy.