What Causes Cerebral Palsy: Complete Guide

Understanding What Causes Cerebral Palsy

Cerebral palsy affects approximately 1 in every 345 children in the United States, making it the most common motor disability in childhood. According to the Centers for Disease Control and Prevention, cerebral palsy is a group of disorders that affect a person’s ability to move and maintain balance and posture. While many families seek answers after a CP diagnosis, understanding the causes can be complex, as multiple factors often contribute to the condition.

The causes of cerebral palsy occur across different stages of development, from conception through early childhood. Research shows that 85% to 90% of cerebral palsy cases are congenital, meaning they occur before or during birth. However, medical advances continue to reveal new insights into genetic contributions, preventable risk factors, and the role of medical care quality in CP outcomes.

What Is Cerebral Palsy and How Does It Develop?

Cerebral palsy is not a single condition but rather a group of permanent movement disorders caused by non-progressive brain injuries or malformations. The term “cerebral” refers to the brain, while “palsy” indicates muscle weakness or control problems. According to the CDC, CP affects approximately 3 out of every 1,000 eight-year-old children in the United States.

The brain damage or abnormal development that causes cerebral palsy affects the motor cortex and other brain regions responsible for movement, balance, and posture. This damage occurs during critical periods of brain development, whether in the womb, during birth, or in early infancy. Unlike progressive conditions that worsen over time, the brain injury in CP remains stable, though the symptoms may change as a child grows and develops.

Types of Brain Damage Leading to Cerebral Palsy

Different types of brain damage can cause cerebral palsy, each affecting movement and coordination in distinct ways:

Causes of Cerebral Palsy Before Birth

The majority of cerebral palsy cases originate before birth, during the critical period of fetal brain development. Multiple factors can interfere with normal brain growth and increase the risk of CP.

Maternal Infections During Pregnancy

According to the CDC’s risk factor guidelines, infections during pregnancy can lead to increases in certain proteins called cytokines that circulate in the brain and blood of the baby. These inflammatory proteins can damage developing brain tissue and increase the risk of cerebral palsy.

Specific infections that raise CP risk include:

• Cytomegalovirus (CMV): One of the most common congenital infections that can cause brain damage when transmitted from mother to fetus.
• Rubella (German measles): Can cause severe fetal brain damage if contracted during early pregnancy.
• Toxoplasmosis: A parasitic infection that can cross the placenta and damage the developing fetal brain.
• Herpes simplex virus: Can be transmitted to the baby during delivery and cause brain inflammation.
• Placental and fetal membrane infections: Infections of the tissues surrounding the baby can trigger inflammatory responses affecting brain development.

Prematurity and Low Birth Weight

Premature birth represents the highest contributing risk factor for cerebral palsy. According to the CDC, children born before the 37th week of pregnancy have a greater chance of developing CP, with significantly elevated risk for those born before the 32nd week.

Birth weight correlates strongly with CP risk. Children who weigh less than 5 pounds, 8 ounces (2,500 grams) at birth face increased risk, and those weighing less than 3 pounds, 5 ounces (1,500 grams) have the greatest vulnerability. Premature infants’ brains are particularly fragile and susceptible to bleeding, oxygen deprivation, and infection.

Multiple Births and Pregnancy Complications

The National Institute of Child Health and Human Development notes that twins, triplets, and other multiple births have a higher risk for cerebral palsy. The risk increases further if a baby’s twin or triplet dies before birth or shortly after birth, potentially due to vascular connections between fetuses or complications affecting the survivor.

Other pregnancy complications that increase CP risk include:

• Placental abnormalities affecting nutrient and oxygen delivery
• Intrauterine growth restriction limiting fetal development
• Maternal health conditions including thyroid problems, seizure disorders, or intellectual disabilities
• Severe maternal hypertension or preeclampsia
• Gestational diabetes not properly managed

Genetic Factors in Cerebral Palsy

Emerging research has revealed that genetic factors play a larger role in cerebral palsy than previously understood. According to recent medical research, up to 30% of individuals with cerebral palsy have a genetic contribution to their condition. This discovery represents a significant shift in understanding CP causes.

Genetic factors can affect brain development through various mechanisms, including gene mutations that disrupt normal neural development, chromosomal abnormalities, and inherited conditions affecting brain structure or function. As genetic testing becomes more sophisticated, researchers continue to identify specific genes associated with increased CP risk.

Causes During Labor and Delivery

While most cerebral palsy cases originate before labor begins, complications during birth can cause or contribute to brain injuries resulting in CP. Understanding these delivery-related causes is particularly important for identifying preventable cases related to medical negligence.

Oxygen Deprivation at Birth

Hypoxic-ischemic encephalopathy (HIE) occurs when a baby’s brain doesn’t receive adequate oxygen and blood flow during labor and delivery. According to birth injury statistics, HIE accounts for approximately 20% of childbirth-related cerebral palsy cases.

Several complications during delivery can cause oxygen deprivation:

Medical providers must monitor fetal heart rate continuously during labor to detect signs of oxygen deprivation. When fetal distress occurs, immediate intervention may be necessary to prevent brain injury.

Birth Trauma and Physical Injury

Physical trauma during delivery can cause bleeding or direct damage to a baby’s brain. This may result from:

• Excessive force during assisted delivery with forceps or vacuum extraction
• Improper use of delivery instruments causing skull fractures or intracranial bleeding
• Excessive pressure on the baby’s head during a difficult delivery
• Rapid or precipitous delivery causing sudden pressure changes

Failure to Perform Timely Cesarean Section

In many cases, performing a cesarean section (C-section) quickly when complications arise can prevent brain injury. Medical negligence may occur when healthcare providers fail to recognize the need for emergency cesarean delivery or delay the procedure despite clear indications of fetal distress.

Situations requiring prompt C-section consideration include:

• Persistent non-reassuring fetal heart rate patterns
• Umbilical cord prolapse or compression
• Placental abruption with fetal compromise
• Failed labor progression with signs of fetal distress
• Uterine rupture or impending rupture

Causes After Birth

Acquired cerebral palsy accounts for 10-15% of all CP cases and results from brain damage occurring more than 28 days after birth. These cases often involve preventable causes where early intervention could have avoided permanent injury.

Severe Jaundice and Kernicterus

According to the CDC, severe jaundice that progresses to kernicterus represents a preventable cause of cerebral palsy. Kernicterus occurs when high levels of bilirubin accumulate in the blood and deposit in brain tissue, causing permanent damage.

Risk factors for severe jaundice include:

• ABO blood type incompatibility between mother and baby
• Rh factor incompatibility if not properly managed
• Premature birth affecting liver function
• Bruising during delivery increasing bilirubin production
• Breastfeeding difficulties leading to dehydration

Healthcare providers should screen all newborns for jaundice and implement treatment with phototherapy or exchange transfusion when bilirubin levels become dangerously elevated. Failure to monitor and treat jaundice appropriately may constitute medical negligence.

Infections in Infancy

Brain infections during the first years of life can cause inflammation and damage resulting in cerebral palsy. Common infections include:

• Bacterial meningitis: Inflammation of the membranes surrounding the brain and spinal cord
• Viral encephalitis: Direct viral infection of brain tissue
• Sepsis: Overwhelming bloodstream infection affecting multiple organs including the brain

Many of these infections are preventable through vaccination and prompt treatment when illness occurs. The NICHD notes that preventable brain infections from missed vaccinations represent an avoidable cause of acquired CP.

Traumatic Brain Injury in Early Childhood

Physical trauma to a child’s head during infancy or early childhood can cause brain damage leading to cerebral palsy. Common causes include:

• Falls from furniture, stairs, or caregivers’ arms
• Motor vehicle accidents without proper restraint
• Abusive head trauma (shaken baby syndrome)
• Near-drowning incidents causing oxygen deprivation
• Accidental poisoning affecting brain function

According to the NICHD, traumatic injuries from inadequate safety precautions or supervision represent preventable causes of acquired cerebral palsy.

Medical Negligence as a Cause of Cerebral Palsy

While not all cerebral palsy cases are preventable, some result from medical errors or negligence during pregnancy, labor, delivery, or newborn care. When healthcare providers fail to meet accepted standards of care, resulting in brain injury and CP, families may have grounds for legal action.

Common Types of Medical Negligence

According to cerebral palsy legal resources, medical negligence contributing to CP may involve:

• Failure to monitor fetal well-being: Not conducting appropriate fetal monitoring during high-risk pregnancies or labor
• Delayed response to fetal distress: Failing to recognize or respond promptly to signs of oxygen deprivation
• Improper use of delivery instruments: Causing head trauma through excessive force or incorrect technique with forceps or vacuum extractors
• Failure to perform timely C-section: Delaying necessary cesarean delivery despite clear indications
• Medication errors: Administering incorrect medications or dosages that harm the baby
• Failure to treat maternal infections: Not diagnosing or treating infections that can be transmitted to the baby
• Inadequate newborn resuscitation: Failing to properly resuscitate a baby who isn’t breathing at birth
• Failure to treat jaundice: Not monitoring bilirubin levels or delaying treatment for severe jaundice

If your child developed cerebral palsy and you suspect medical errors contributed to the condition, preserve all medical records and consult with legal professionals experienced in birth injury cases. Time limits apply for filing medical malpractice claims, so early consultation is important.

Standards of Care Healthcare Providers Must Follow

Medical professionals have specific obligations during pregnancy, labor, and delivery to prevent brain injuries:

Risk Factors That Increase Cerebral Palsy Likelihood

While risk factors don’t guarantee a child will develop cerebral palsy, they significantly increase the likelihood. Understanding these factors helps identify pregnancies and deliveries requiring enhanced monitoring and care.

Maternal Health Risk Factors

The CDC identifies several maternal health conditions that slightly elevate CP risk:

• Thyroid problems affecting hormone levels during pregnancy
• Seizure disorders requiring medication that may affect fetal development
• Intellectual or developmental disabilities
• Excessive protein in urine indicating kidney problems or preeclampsia
• Chronic hypertension or pregnancy-induced high blood pressure
• Diabetes (preexisting or gestational) not well controlled

Pregnancy and Birth Characteristic Risk Factors

Certain pregnancy and birth characteristics substantially increase cerebral palsy risk:

Environmental and Exposure Risk Factors

According to the NICHD, exposure to toxic chemicals during pregnancy can increase cerebral palsy risk. Specific concerns include:

• High-level methyl mercury exposure from contaminated fish
• Lead exposure from old paint or contaminated water
• Certain medications that affect fetal brain development
• Alcohol consumption during pregnancy
• Illicit drug use affecting fetal development

Prevention Strategies and Risk Reduction

While not all cerebral palsy cases can be prevented, understanding risk factors enables healthcare providers and expecting parents to take steps that reduce the likelihood of brain injury.

Prenatal Prevention Measures

According to cerebral palsy prevention guidelines, several prenatal measures can lower CP risk:

• Early and consistent prenatal care: Regular checkups allow healthcare providers to monitor fetal development, identify complications early, and manage maternal health conditions
• Vaccination: Ensuring immunity to rubella and other infections before pregnancy prevents congenital infections that can damage the fetal brain
• Rh factor testing and treatment: Identifying Rh incompatibility and administering Rh immunoglobulin prevents immune system attacks on the fetus
• Chronic condition management: Properly controlling diabetes, hypertension, thyroid disorders, and other health conditions reduces pregnancy complications
• Infection prevention and treatment: Promptly diagnosing and treating infections during pregnancy prevents transmission to the baby
• Avoiding harmful substances: Eliminating alcohol, tobacco, and illicit drugs during pregnancy protects fetal brain development

Labor and Delivery Prevention Measures

Healthcare providers can implement several strategies during labor and delivery to prevent brain injuries:

• Continuous fetal monitoring: Regularly checking fetal heart rate helps detect oxygen deprivation early when intervention can prevent injury
• Timely intervention for fetal distress: Responding promptly to signs of distress with position changes, oxygen administration, or emergency delivery
• Appropriate use of delivery assistance: Using forceps and vacuum extractors only when indicated and with proper technique
• Judicious cesarean section decisions: Performing C-sections when vaginal delivery poses excessive risk to the baby
• Proper newborn resuscitation: Having trained personnel and equipment immediately available to resuscitate babies who aren’t breathing

Postnatal Prevention Measures

After birth, several interventions can prevent acquired cerebral palsy:

• Jaundice screening and treatment: Monitoring all newborns for elevated bilirubin and treating with phototherapy or exchange transfusion when necessary
• Vaccination schedule adherence: Following recommended immunization schedules prevents brain infections like meningitis
• Safety precautions: Using proper car seats, preventing falls, ensuring safe sleep environments, and supervising children to prevent traumatic injuries
• Prompt medical attention for illness: Seeking immediate care when infants show signs of serious infection or illness

The Role of Early Diagnosis in Understanding Causes

Determining what caused a specific child’s cerebral palsy often requires thorough medical investigation. Early diagnosis not only helps families understand their child’s condition but also identifies preventable causes that may involve medical negligence.

Diagnostic Investigations

Healthcare providers use various tools to investigate CP causes:

• Medical history review: Examining pregnancy, labor, delivery, and early childhood records for complications or concerning events
• Brain imaging: MRI or CT scans reveal structural brain abnormalities, bleeding, or damage patterns that indicate timing and nature of injury
• Genetic testing: Identifying genetic mutations or chromosomal abnormalities that contributed to abnormal brain development
• Metabolic testing: Screening for metabolic disorders that can affect brain function
• Developmental monitoring: Tracking developmental milestones helps identify when brain injury likely occurred

Importance of Medical Record Preservation

Families concerned about potential medical negligence should obtain and preserve complete medical records from pregnancy, delivery, and newborn care. These records provide essential documentation for understanding what occurred and whether healthcare providers met applicable standards of care.

If your child’s medical records reveal concerning complications during pregnancy, labor, or delivery, or if healthcare providers seemed unprepared or slow to respond to problems, consulting with an attorney experienced in birth injury cases can help you understand whether negligence contributed to your child’s condition.

Current Research on Cerebral Palsy Causes

Medical research continues to reveal new insights into cerebral palsy causes and prevention. According to recent scientific publications, as of November 2025, there are 377 clinical trials and research studies actively recruiting participants worldwide to better understand CP causes and develop preventive strategies.

Emerging Areas of Research

Current cerebral palsy research focuses on several promising areas:

• Genetic contributions: Identifying specific genes and genetic variations that increase CP risk or directly cause the condition
• Inflammatory pathways: Understanding how maternal and fetal inflammation damages developing brain tissue
• Neuroprotective treatments: Developing interventions that protect the brain during high-risk periods
• Biomarkers for early detection: Identifying measurable indicators that predict which infants will develop CP
• Stem cell therapies: Exploring whether stem cells can repair damaged brain tissue
• Global CP prevention: Implementing evidence-based prevention strategies in regions with high CP rates

Shifting Understanding of Oxygen Deprivation

Recent research has shifted perspectives on the role of oxygen deprivation at birth. While lack of oxygen during delivery can certainly cause cerebral palsy, emergent research shows there are many other causes and risk factors. It is now believed that CP often results from a series of events that combine to cause injury to the brain during the developmental period, rather than a single incident.

Living Costs and Financial Impact

Understanding what causes cerebral palsy also means recognizing the significant financial burden families face. According to the CDC, the lifetime cost to care for someone with cerebral palsy exceeds $1.6 million. These costs include therapy, medications, assistive devices, home modifications, and ongoing medical care.

When cerebral palsy results from medical negligence, families may be entitled to compensation covering:

• Past and future medical expenses
• Therapeutic interventions and rehabilitation
• Assistive technology and mobility devices
• Home and vehicle modifications
• Lost parental income from caregiving responsibilities
• Pain and suffering experienced by the child and family
• Reduced earning capacity for the affected individual

Taking Action: Legal Rights When Medical Negligence Causes Cerebral Palsy

Families whose children develop cerebral palsy due to preventable medical errors have legal rights to pursue compensation. Medical malpractice laws recognize that healthcare providers must meet established standards of care, and when failures cause harm, they should be held accountable.

Steps to Consider If You Suspect Medical Negligence

If you believe medical errors contributed to your child’s cerebral palsy, consider these steps:

• Obtain complete medical records: Request all records from pregnancy, labor, delivery, and newborn care from every provider and facility involved
• Preserve documentation: Keep records of all medical expenses, therapy costs, and other financial impacts of your child’s condition
• Consult legal professionals: Speak with attorneys experienced in birth injury and medical malpractice cases who can evaluate whether negligence occurred
• Understand time limits: Each state has statutes of limitations that restrict how long you have to file legal claims, so timely consultation is important
• Consider expert review: Medical experts can analyze your records to determine whether care met accepted standards

Conclusion: Understanding Causes Empowers Families

Cerebral palsy results from diverse causes affecting brain development before birth, during delivery, or in early childhood. While approximately 85-90% of cases are congenital, recent research reveals that genetic factors contribute to up to 30% of cases, significantly expanding our understanding beyond traditional birth injury causes.

Key contributing factors include prematurity and low birth weight, maternal infections during pregnancy, oxygen deprivation during delivery, genetic variations affecting brain development, and preventable medical errors. Some cases result from medical negligence when healthcare providers fail to properly monitor pregnancies, respond to fetal distress, manage deliveries safely, or provide appropriate newborn care.

Understanding what causes cerebral palsy helps families make sense of their child’s diagnosis, enables healthcare providers to implement prevention strategies, and identifies cases where legal action may be appropriate. While not all CP cases can be prevented, proper medical care can reduce many risk factors and prevent brain injuries that lead to permanent disabilities.

For families facing cerebral palsy diagnoses, knowing the cause—when it can be determined—provides important information for medical management, helps identify whether negligence occurred, and may open pathways to financial compensation that can help cover the substantial lifetime costs of care estimated at over $1.6 million per person by the CDC.