# Is Low Maternal Oxygen Tied to Cerebral Palsy Development?
Yes, low oxygen supply to a baby during pregnancy, labor, or delivery is directly connected to cerebral palsy development. When a newborn does not receive enough oxygen, it can cause serious brain damage that leads to cerebral palsy and other long-term neurological problems.
## How Oxygen Deprivation Causes Brain Damage
During labor and delivery, babies depend on a steady supply of oxygen through the umbilical cord and placenta. When this oxygen supply is interrupted, the baby’s brain cells can be damaged or die. This condition is called hypoxic-ischemic encephalopathy, or HIE, which refers to brain dysfunction caused by insufficient oxygen and inadequate blood flow to the newborn’s brain.
The timing and length of oxygen deprivation matter greatly. Even a difference of a few minutes can affect long-term outcomes. When oxygen deprivation lasts longer, the damage tends to be more severe. Mild cases may result in temporary complications that resolve with minimal impairment, while moderate to severe cases can lead to permanent conditions like cerebral palsy, epilepsy, cognitive impairment, and vision or hearing deficits.
## The Connection Between HIE and Cerebral Palsy
Research shows that patients with HIE are significantly more likely to develop cerebral palsy. About 15 to 20 percent of infants affected by perinatal asphyxia may not survive the neonatal period, and around 25 percent of survivors face severe, lasting neurological deficits. Cerebral palsy is the most serious neurological consequence of perinatal asphyxia, which is the medical term for oxygen deprivation during birth.
The severity of early hypoxic-ischemic injury is critical for determining long-term outcomes. In preterm infants, immature autoregulation and systemic hypoxia contribute to selective vulnerability of the periventricular white matter, which increases the risk of cerebral palsy development.
## What Causes Low Oxygen During Labor
Several situations during labor and delivery can reduce oxygen supply to the baby. Prolonged labor, where the process lasts much longer than typical, increases the risk of oxygen deprivation. When the cervix does not dilate properly or the baby does not move down the birth canal, complications like fetal distress and birth asphyxia can occur.
Other causes include entanglement in the umbilical cord, umbilical cord prolapse where the cord leaves the uterus prematurely, and shoulder dystocia, where the baby’s shoulders become stuck behind the mother’s pelvic bone after the head is delivered. Low blood pressure in the mother, abnormalities of the uterus or placenta, and extreme blood loss after birth can also reduce oxygen flow to the baby.
The use of synthetic oxytocin, commonly known as pitocin, to start or increase contractions during prolonged labor can also be harmful. This medication can cause uterine hyperstimulation, where contractions become too strong, too frequent, or too long, depriving the baby of oxygen and increasing the risk of cerebral palsy and other birth injuries.
## Genetic Factors and Brain Damage
While oxygen deprivation is a major cause of cerebral palsy, research indicates that genetic factors also play a role. Studies using MRI imaging found that about 92 percent of children with cerebral palsy showed signs of brain injury, while only 8 percent had normal scans. However, genetic factors were found in about one quarter of all children with cerebral palsy, including some children with various types of brain injury patterns.
One specific genetic finding involves the MMP2 gene promoter. The ATG haplotype of the MMP2 promoter was significantly more common among patients who developed cerebral palsy after perinatal asphyxia. This genetic variation may serve as a risk factor or potential diagnostic predictor of cerebral palsy in patients who experience oxygen deprivation during birth.
## Prevention and Early Detection
HIE is often preventable when warning signs are recognized and acted upon promptly. Fetal monitoring can show non-reassuring heart rate patterns that suggest a baby is struggling. Medical guidelines emphasize that these warning signs must be investigated and addressed immediately. Delays in performing a cesarean section when labor is not progressing or when the fetus shows signs of oxygen deprivation can have serious consequences.
Newborns with HIE may show signs at birth including low Apgar scores, poor muscle tone, abnormal breathing, or seizures. Some infants require immediate resuscitation or specialized treatment such as therapeutic hypothermia. Over time, symptoms may evolve to include feeding challenges, developmental delays, movement difficulties, or variations in muscle tone.
Diagnosis is typically confirmed through imaging studies such as MRI, along with assessments by neonatologists or neurologists. Early detection and intervention can help manage symptoms and improve outcomes for affected children.
## Sources
https://pmc.ncbi.nlm.nih.gov/articles/PMC12731818/
https://www.childbirthinjuries.com/blog/prolonged-labor-effects-on-baby-complications/
https://www.bila.ca/prolonged-labour-effects-on-baby/