A study from 2010 indicates that infants of African-American mothers may
have a higher chance of being diagnosed with
cerebral palsy. This increase may to be tied to their greater chances of being born underweight.
This supposition is due to the fact that when birth weight is taken out
of the equation, African-Americans are actually less likely than Caucasians
to be diagnosed with the motor-neurologic disorder. The reason for this
disparity is unknown, says Dr. Yvonne Wu, a pediatric neurologist working
at the University of California, San Francisco, who was the lead on the study:
“Low birth weight infants have a much higher risk of cerebral palsy.
If we could eliminate the racial disparity in low birth weight deliveries,
then we would also eliminate the differences in cerebral palsy between
blacks and whites.”
Large population studies like this one are very useful in determining correlations
between race and incidents of the different types of cerebral palsy. Dr.
Nancy Murphy, a pediatrician at the University of Utah in Salt Lake City,
and chair of the American Academy of Pediatrics Council on Children With
Disabilities, highlights the need for more research in this are:
“We need these big population studies to get at those kind of details."
There are other possible causes of the higher incidence of cerebral palsy
among black mothers. Access to healthcare, especially prenatal care, can
be limited in lower income areas and among specific socioeconomic groups,
such as minorities and those in poverty. This study in particular states
that increased availability of prenatal care might help to reduce the
incidence of cerebral palsy in the African-American population. Early,
and good quality prenatal care tends to lead to healthier babies; women
without access to these resources tend to be at risk for traumatic deliveries.
Tremendous pressure by hospital institutions on obstetricians to reduce
the number of
C-sections in general, and specifically for those on Medicaid (due to the fact that
hospitals tend to be paid a lower rate for expensive surgical procedures
by Medicaid than by private insurance) may also be part of the problem.
When mothers are high risk, with preeclampsia, excessive weight gain in
pregnancy, gestational diabetes, LGA (large for gestational age) babies,
or just a first time mother, placental abruption or a size difference
between the baby and the mother's birth canal may occur, leading to
hypoxia-ischemia, a leading cause of cerebral palsy.
For the 2010 study, which was published in the Journal of Pediatrics, Dr.
Wu and her team reviewed medical records of 6.2 million births in the
state of California from 1991-2000. In this population, 8,400 infants
had been diagnosed with cerebral palsy, which was a rate of 1.4 cases
per 1,000 live births.
2 and 2.5 cases per 1,000 live births is about the normal rate, but Wu
and her team did not include children with mild cases of cerebral palsy
who did not qualify for state services.
Of the infants in this population, 758 were black, 2,878 were white, 3,963
were Hispanic and 656 were Asian.
African-Americans had about a 30 percent higher chance that Caucasians
to be diagnosed with cerebral palsy in this study population. Among Hispanics,
the rates were about the same as Caucasians, while Asian-Americans had
the lowest incidence of the condition.
Premature or underweight infants were up to 24 times more likely to be
diagnosed with cerebral palsy. Both of these risk factors were much more
common among African-Americans than the other groups in the population,
which could be accounted for by less access to healthcare. Those who did
not graduate from high school also had a higher risk.
Birth injuries, or incidents of cerebral palsy caused by vacuum-assisted
vaginal delivery, forceps, or use of Pitocin for vaginal delivery were
not examined in this case study.
Birth injuries are a common cause of cerebral palsy in children, accounting for, by some
sources, up to 10% of all cases in the United States. If you or your child
have been a victim of medical malpractice, and your child has been diagnosed
with cerebral palsy, it may be a good idea to contact a Chicago birth