Even Mild Preterm Brain Injuries Increase Risks of Cerebral Palsy and Developmental Disorders: Study

White matter injuries suffered by preterm infants increased their risk of cerebral palsy by a factor of 15.

According to the findings of a new study, if premature infants experience even a mild brain bleed or brain injury, they face an increased risk of cerebral palsy and other cognitive impairments.

Researchers from the U.K. report that mild intraventricular hemorrhage (IVH) and white matter injuries (WMI) suffered by preterm infants led to an increased risk of cerebral palsy, cognitive impairments, as well as hearing and vision problems. Their findings were published on November 4 in the medical journal Pediatrics.

Cerebral palsy (CP) is a childhood-onset motor disability, affecting more than 700,000 people in the United States. Symptoms of cerebral palsy include exaggerated reflexes, developmental delays, involuntary motions, and floppy or rigid limbs, resulting in a permanent disability that limit activity by impairing a person’s ability to move, maintain balance, and maintain posture.

Complications during pregnancy and delivery, which result in brain birth injuries, are often identified as the cause of cerebral palsy, and families have been awarded millions in damages through medical malpractice lawsuits where cerebral palsy was caused by a mistake that could have been avoided.

In this latest report, researchers looked at observational studies across 10 databases, which were conducted between 2000 and 2021. They looked for three-year neurodevelopmental outcomes for preterm infants who suffered IVH or WMI injuries, compared to those who did not.

IVH injuries are graded from 1-4, with Grades 1 and 2 considered mild, and grades 3 and 4 considered more severe.

According to the findings, preterm infants who suffered only grade 1 and 2 IVH injuries faced a 35% increased risk of moderate to severe neurodevelopmental impairment overall; including a 76% higher risk of cerebral palsy, a 79% increased risk of cognitive problems, and a 77% increased risk of visual impairments.

For those with grade 3 and 4 IVH injuries, those numbers jumped significantly, with those infants facing a nearly five-fold increased risk of cerebral palsy, nearly triple the risk of motor developmental problems, more than five times the risk of visual impairment and more than double the risk of cognitive and hearing problems. However, the highest risks were found among preterm infants who suffered any kind of white matter injury, with a nearly 15-fold increased risk of cerebral palsy, five times the risk of motor developmental problems, and more than triple the risk of cognitive impairment.

The study’s authors said far more specific research is needed into this area of study, as evidenced by a lack of some types of data, such as follow-ups later in life, and the heterogeneity of those previous studies, in order for the medical community to get a better understanding of the scope and impact of preterm IVH and white matter injuries.

“In this review, we were unable to explore trajectories after preterm brain injuries, ie, to determine whether these adverse neurodevelopmental outcomes persist, worsen, or even improve throughout childhood,” the researchers concluded. “However, this should be a priority question in future studies as 3-year outcomes are not necessarily predictive of school-aged outcomes.”