Patient's question:
The child is 5 months old and does not recognize people, cannot sit, often clenches their fists, and their heels do not touch the ground.Doctor's answer:
1. Before birth: It was previously believed that fetal hypoxic-ischemic brain injury was mainly caused by conditions such as gestational toxicity, diabetes, and placental dysfunction. Current research indicates that intrauterine infection, particularly early pregnancy infection with rubella virus, herpes virus, cytomegalovirus, and toxoplasma, is a significant factor. Additionally, extensive studies have confirmed that half of children with cerebral palsy have a history of premature birth and low birth weight. Furthermore, pediatric cerebral palsy is closely associated with adverse lifestyle factors during pregnancy, including poor nutrition, environmental pollution, illness (e.g., fever, urinary tract infections), drug abuse, alcoholism, advanced maternal age, multiple pregnancies (twins or more), and fetal brain malformations. Some non-spastic types of cerebral palsy, especially ataxic cerebral palsy, are also linked to genetic factors.2. During birth (perinatal period): The main factors include hypoxia, premature birth, intracranial hemorrhage, and hyperbilirubinemia. Hypoxia can be caused by various factors, such as poor placental function, placental abruption, umbilical cord torsion, nuchal cord, and other conditions leading to intrauterine (or neonatal) asphyxia. Intracranial hemorrhage is often related to difficult labor and birth injuries. Hyperbilirubinemia may result from blood type incompatibility between mother and child or other causes. When bilirubin levels exceed 340 μmol/L (20 mg/dL), the risk of developing kernicterus increases. The high prevalence of cerebral palsy among premature infants may be due to their increased susceptibility to hypoxia and intracranial hemorrhage. The smaller the birth weight, the higher the likelihood of developing cerebral palsy.
3. After birth: It typically occurs within the first four weeks of life, involving various intracranial infections, head trauma, bilirubin encephalopathy, and carbon monoxide poisoning.