Can extreme prematurity cause lifelong cerebral palsy?
In short, extreme prematurity greatly increases the risk of cerebral palsy, and when cerebral palsy develops, it is usually a lifelong condition. However, not every baby born very early will have cerebral palsy, and many extremely premature babies grow up without major movement disabilities.
Cerebral palsy is a group of disorders that affect movement, posture, and muscle tone. It happens because of abnormal brain development or damage to the developing brain, usually before birth, during birth, or shortly after birth. The damage affects the parts of the brain that control movement and coordination, so children may have stiff or floppy muscles, poor balance, or difficulties with fine motor skills. This brain injury does not get worse over time, but its effects are long term and can last throughout life. https://cerebralpalsyguidance.com/2025/12/12/researchers-use-mri-to-diagnose-find-causes-of-cerebral-palsy-in-children/
To understand how extreme prematurity fits in, it helps to look at what “extreme” means. Doctors usually call a birth “very preterm” if it happens before 32 weeks of pregnancy and “extremely preterm” if it happens before 28 weeks. The earlier a baby is born, the more immature the brain, lungs, and other organs are, which makes the baby much more fragile. Research shows that premature babies account for roughly one third to one half of all cerebral palsy cases. In one review of children with cerebral palsy, more than half were born prematurely, and babies born before 28 weeks had the highest risk. https://www.nationalbirthinjurylaw.com/what-causes-cerebral-palsy A large scientific review also confirms that preterm birth is a major risk factor for cerebral palsy and that risk rises as gestational age and birth weight fall. https://pmc.ncbi.nlm.nih.gov/articles/PMC12767667/
Some studies estimate that up to about 15 percent of babies born between 24 and 27 weeks of pregnancy may later be diagnosed with cerebral palsy. https://www.nationalbirthinjurylaw.com/what-causes-cerebral-palsy That means the majority of extremely premature babies do not develop cerebral palsy, but the risk is clearly much higher than for babies born at full term.
Why extreme prematurity raises the risk
Extreme prematurity on its own does not “cause” cerebral palsy in a simple, direct way. Instead, being born very early exposes the baby to several harmful conditions that can damage the developing brain.
Researchers describe a mix of overlapping factors:
1. Lack of oxygen and blood flow
Very premature babies often have breathing problems and unstable blood pressure. This can reduce the amount of oxygen and blood reaching the brain, sometimes leading to hypoxic ischemic injury, which is a kind of brain damage caused by too little oxygen and blood flow. https://www.nationalbirthinjurylaw.com/what-causes-cerebral-palsy Even short periods without enough oxygen can injure vulnerable brain tissue and increase the risk of cerebral palsy.
2. Fragile brain structures and bleeding
In extremely preterm babies, the white matter near the brain’s fluid-filled spaces and the small blood vessels are very delicate. These babies are more prone to bleeding in the brain or to a type of white matter injury often seen in preterm infants. Such injuries can disrupt the pathways that control movement and muscle tone and are strongly linked to cerebral palsy. https://pmc.ncbi.nlm.nih.gov/articles/PMC12767667/
3. Inflammation and infection
Premature babies, especially those in the neonatal intensive care unit, have weaker immune systems and are more vulnerable to serious infections such as sepsis, meningitis, or severe respiratory infections. These infections can cause intense inflammation in the brain and may lead to long term injury that contributes to cerebral palsy. https://www.orangehealthcare.in/uncategorized/severe-infections-in-infants-leading-to-cerebral-palsy-causes-early-signs-and-prevention/ Infections before birth, such as chorioamnionitis, also raise the risk of both prematurity and brain damage.
4. Complications around birth
Conditions like placental insufficiency, placental abruption, or problems with the umbilical cord can reduce oxygen and nutrient delivery to the baby. These complications are linked to premature delivery, low birth weight, and a higher risk of hypoxic ischemic encephalopathy, which is a major pathway to cerebral palsy. https://www.nationalbirthinjurylaw.com/what-causes-cerebral-palsy Hospitals may use treatments such as careful neonatal resuscitation and brain cooling (therapeutic hypothermia) in certain cases to lessen the risk of permanent injury.
5. Other medical and genetic factors
Not all cerebral palsy in premature babies is purely due to prematurity. MRI and genetic research suggest that some children have underlying genetic factors that make their brains more vulnerable, or that directly contribute to abnormal brain development. https://cerebralpalsyguidance.com/2025/12/12/researchers-use-mri-to-diagnose-find-causes-of-c
