Can maternal drug use increase cerebral palsy risk?
Cerebral palsy is a group of disorders that affect a person’s ability to move and keep their balance. It often starts in early childhood and is caused by damage to the developing brain. One question parents and doctors sometimes ask is whether drugs a mother takes during pregnancy can raise the chance of her baby developing cerebral palsy.
Certain medications used in pregnancy have been studied for possible links to cerebral palsy. For example, a 2018 study from the University of Copenhagen looked at almost 190,000 mother-child pairs in Denmark. Researchers found that mothers who took aspirin during pregnancy were 2.4 times more likely to have a child with bilateral spastic cerebral palsy compared to those who did not take it.[1] The study also noted that acetaminophen use was linked to a 30 to 60 percent higher risk of cerebral palsy diagnoses. However, a later study in the Journal of Pediatrics, which examined 923 cerebral palsy cases in Sweden from 1995 to 2014, found no increased risk from acetaminophen taken early in pregnancy.[1]
Other drugs can play a role too. Labor-inducing medications like Pitocin and Cytotec are sometimes given when contractions are weak or labor is prolonged. If the dose is too high, it can cause uterine hyperstimulation, which reduces oxygen to the baby. This lack of oxygen, called hypoxia, can lead to brain damage and cerebral palsy.[2] Misuse of these drugs by doctors or nurses counts as medical error and is preventable in many cases.[2]
Substance abuse is another concern. Chemical or substance abuse during pregnancy is listed as a risk factor for cerebral palsy by experts at Children’s Hospital of Philadelphia.[6] This includes illegal drugs or misuse of legal ones, which can harm the baby’s brain development. A systematic review also looked at antihypertensive medications, used for high blood pressure in pregnancy, and their ties to poor neurodevelopmental outcomes, though specific cerebral palsy links were not detailed.[5]
Not all drugs raise the risk equally, and studies sometimes disagree. For instance, while one study flagged aspirin, results vary based on the type of drug, timing, and dose. Doctors weigh benefits against risks when prescribing anything during pregnancy.
Prematurity often ties into these risks. Babies born before 28 weeks have the highest chance of cerebral palsy, and up to 15 percent of very early preterm babies develop it.[2] Drugs that lead to early delivery or complications like placental abruption can worsen this. Placental abruption cuts off oxygen and nutrients to the baby, raising cerebral palsy odds.[2] Extremely preterm infants, born before 27 weeks, show rising cerebral palsy rates due to better survival from neonatal care, but also issues like brain bleeding or infections.[4]
Infections or illnesses during pregnancy might require medications, which can help but carry risks if not managed right.[2] Overall, while some maternal drug use links to higher cerebral palsy risk through oxygen loss or direct brain effects, many cases stem from multiple factors like preterm birth or birth complications.
Sources
https://www.bila.ca/does-aspirin-use-during-pregnancy-increase-the-risk-of-cerebral-palsy/
https://www.nationalbirthinjurylaw.com/what-causes-cerebral-palsy
https://pmc.ncbi.nlm.nih.gov/articles/PMC12748543/
https://childrenscerebralpalsy.com/news/
https://acamh.onlinelibrary.wiley.com/doi/full/10.1002/jcv2.70080
https://www.chop.edu/conditions-diseases/cerebral-palsy
