03:57am Friday 18 October 2019

Infections increase the risk of developing CP

CP is a group of motion disorders that are caused by an injury to the, as yet, immature brain. Approximately half of all children with CP also have other medical conditions such as cognitive disabilities and epilepsy.

Previously, it was believed that the most important causes of CP were complications during delivery, for example uterine rupture, umbilical cord prolapse or abruption of the placenta and lack of oxygen to the baby. Studies have shown, however, that a lack of oxygen only explains a smaller portion of all CP cases, which is why it is very important to continue studying other factors in order to eventually be able to prevent brain damage.

Infections associated with CP

A new thesis at Sahlgrenska Academy, University of Gothenburg, includes four different studies that encompass 309 children with CP, born at full term in Västra Götaland in the 1980s and 1990s, as well as a control group of 618 healthy children.

“The results show that there is an association between infection in the pregnant mother and a type of CP that affects one side of the body, while the type of CP that affects both sides of the body is linked to infections in the baby after delivery,” says Kristina Ahlin, PhD student at Sahlgrenska Academy.

Classified by symptoms

CP is classified by the dominant neurological symptom and can also be divided by severity of motor impairment.

“By studying the risk factors for CP associated with the different severity of motor impairment, we can better generate hypotheses on the mechanisms behind severe CP, and in the long run, gain the opportunity to prevent severe impairment” says Kristina Ahlin.

Risk factors

In her thesis, Kristina Ahlin investigated, among other things, which risk factors are associated with the different subtypes of CP, if infections during pregnancy and delivery are linked to an increased risk of CP, as well as if risks differ for the different CP subtypes.

She also studied if the risk factors and brain imaging patterns differ between the various degrees of CP severity, as well as which risk factors and brain imaging patterns are associated with the development of CP and concurrent expression of epilepsy and cognitive disabilities.

Possible pathways

The studies indicate three possible common pathways to CP: hypoxia (lack of oxygen to the baby), infection and malformations. Possible mechanisms for how and when the injury may have arisen was suggested for the different CP subtypes and severity of motor impairment. The findings were confirmed by results from diagnostic brain imaging.

“This provides an important basis for further study of possible mechanisms behind CP and the development of preventative strategies,” says Kristina Ahlin.

The thesis, Antecedents of cerebral palsy in children born at term – according to subtype, motor severity and accompanying impairments, was defended February 26 th.

Link to the thesis

Two of the substudies that are included in the thesis have previously been published in the renowned scientific journals the British Journal of Obstetrics and Gynaecology (BJOG) and Obstetrics and Gynecology.

Sub types of CP:
CP is divided into spastic, akinetic or dyskinetic CP. Spastic CP, in turn, is divided into spastic hemiplegia, spastic diplegia or spastic tetraplegia, depending on which parts of the body that are affected.
The degree of motor severity is divided into mild (walks), moderate (walks with aids) and severe (cannot walk).

Kristina Ahlin, PhD student at Sahlgrenska Academy, University of Gothenburg, and Resident Physician at Närhälsan

Bo Jacobsson, Professor at Sahlgrenska Academy

BY: Johanna Hillgren

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