Does Premature Birth Cause Cerebral Palsy?
Premature birth does not directly cause cerebral palsy, but it greatly raises the risk, especially in babies born before 27 weeks of pregnancy. Extremely preterm infants face higher chances of brain injuries that can lead to this condition.
Cerebral palsy happens when the brain gets damaged before, during, or soon after birth, affecting movement and muscle control. For preterm babies, their brains are still developing and very sensitive. Things like low oxygen, infections, or bleeding in the brain can harm it. Studies show that premature babies make up 33 to 50 percent of all cerebral palsy cases. One review of medical records found that over half of 206 children with cerebral palsy were born too early, with the highest risk for those born before 28 weeks.
Research from the Eunice Kennedy Shriver National Institute of Child Health and Human Development tracked extremely preterm babies born before 27 weeks from 2008 to 2019. When these children were checked at 18 to 26 months old, doctors saw more cases of cerebral palsy over time. This rise links to issues like low birth weight, late onset sepsis, intraventricular hemorrhage, periventricular leukomalacia, and severe lung disease needing a ventilator.
Preterm brains are prone to white matter injury because cells called pre-oligodendrocytes are vulnerable to stress, lack of blood flow, inflammation, and oxygen problems between 23 and 32 weeks of gestation. MRI scans often show these injuries in children with cerebral palsy, with white matter damage being the most common type at 46.5 percent. Preterm birth strongly ties to this pattern, which often leads to spastic cerebral palsy.
Other factors play a role too. Birth complications like placental abruption or insufficiency can cut off oxygen and nutrients, causing hypoxic ischemic encephalopathy, a common path to cerebral palsy. Genetics can also contribute, even with brain injuries visible on scans. About one quarter of children with cerebral palsy have genetic factors, and some have no MRI signs of injury at all.
Better care in neonatal units has helped more preterm babies survive, but it has not fully lowered cerebral palsy rates. Improved diagnosis, like watching development over time or using new tools such as MRI patterns and brain monitoring caps, spots the condition earlier. Early interventions give these children the best shot at better outcomes.
Sources
https://childrenscerebralpalsy.com/research-update-increased-prevalence-of-cerebral-palsy-in-extremely-preterm-infants/
https://www.nationalbirthinjurylaw.com/what-causes-cerebral-palsy
https://cerebralpalsyguidance.com/2025/12/12/researchers-use-mri-to-diagnose-find-causes-of-cerebral-palsy-in-children/
https://pmc.ncbi.nlm.nih.gov/articles/PMC12754938/
https://www.cerebralpalsyguide.com/blog/new-swimming-cap-early-diagnosis-of-cerebral-palsy-in-infants/
