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Cerebral Palsy, preterm birth, and Vitamin D

Can you prevent Cerebral Palsy? Here’s how Vitamin D could play a powerful role in preventing CP

Online Aug 2017
South African mother, who is a hospital doctor, gave birth prematurely and her daughter had Cerebral Palsy
She later learned about the great reduction in premature births by the efforts of Grassroots Health

  • Just to make the link to CP clear – Cerebral Palsy occurs in 60% of all premature births and is associated with intra-uterine infections of pregnancy.
  • If you can prevent infections and premature birth, you can very likely help prevent Cerebral Palsy.

From the Web

Cerebral Palsy—Trends in Epidemiology and Recent Development in Prenatal Mechanisms of Disease, Treatment, and Prevention Feb 2017
Full free PDF online

  • "Overall, the total rate of CP is relatively stable, yet the contribution of prematurity and its complication to the prevalence of this syndrome are steadily increasing due to improvements in obstetric and neonatal care"
  • "Any intervention that will lead to modification of the risk factors for CP as well as for the prevention or treatment of the underlying mechanisms that leads to this syndrome eventually will affect its prevalence."


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CP Risk Factors

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What are the risk factors for cerebral palsy? NIH

  • Low birth weight or preterm birth. Infants born preterm (defined as before 37 weeks of pregnancy) and infants who weigh less than 5.5 pounds at birth are at greater risk of cerebral palsy than are early term (defined as 37 weeks to 38 weeks of pregnancy) and full-term (defined as 39 weeks to 40 weeks of pregnancy) infants and those who are heavier at birth. The earlier the birth and the lower the infant’s birthweight, the greater the risk.
  • Multiple gestations. Twins, triplets, and other multiple births are at higher risk of cerebral palsy. The risk is also greater for an infant whose twin or triplet dies before or shortly after birth.
  • Infertility treatments. Infants born from pregnancies resulting from the use of certain infertility treatments are at higher risk for cerebral palsy than are infants born from pregnancies not related to infertility treatments. Much of this increased risk may be due to the fact that infertility treatments are more likely to result in preterm delivery and multiple gestations.
  • Infections during pregnancy. Toxoplasmosis, rubella (German measles), cytomegalovirus, and herpes can infect the womb and placenta, leading to brain damage in the fetus.
  • Fever during pregnancy. Sometimes fever in the mother during pregnancy or delivery can lead to brain damage in the fetus, resulting in cerebral palsy.
  • Blood factor between mother and fetus does not match. Those who have a certain protein found on red blood cells—abbreviated Rh—are Rh positive; those who do not have the protein are Rh negative. If a mother’s Rh factor is different from that of the fetus, her immune system may attack the blood cells of the fetus, including blood cells in the brain, which can lead to brain damage.
  • Exposure to toxic chemicals. If a mother is exposed to a toxic substance, such as high levels of methyl mercury (found in some thermometers and in some seafood), during pregnancy the fetus is at higher risk of cerebral palsy.
  • Maternal medical conditions:
    • Abnormal thyroid function
    • Intellectual and developmental disability
    • Too much protein in the urine
    • Seizures
  • Complicated labor and delivery. Infant heart or breathing problems during labor and delivery and immediately after birth increase the risk of cerebral palsy.
  • Jaundice (pronounced JAWN-dis). Jaundice, which causes an infant’s skin, eyes, and mouth to turn a yellowish color, can be a sign that the liver is not working normally. Jaundice occurs when a substance called bilirubin (pronounced BIL-uh-roo-bin) builds up faster than the liver can clear it from the body. This condition is common and is usually not serious. However, in cases of severe, untreated jaundice, the excess bilirubin can damage the brain and cause cerebral palsy.
  • Seizures. Infants who have seizures are more likely to be diagnosed with cerebral palsy later in childhood.

Some risk factors for acquired cerebral palsy are;

  • Infancy. Infants are at greater risk than older children for an event that causes brain damage.
  • Preterm or low birthweight. Children born preterm or at a low birthweight have a higher risk for acquired cerebral palsy.
  • Not getting certain vaccinations. Childhood vaccinations can prevent brain infections that can cause cerebral palsy.
  • Injury. Not taking certain safety precautions for infants or lack of adult supervision can lead to injury that can cause cerebral palsy.

Most of the CP risk factors are also risk factors for low vitamin D - even twins or infertility treatments. Observation by VitaminDWiki


Vitamin D in Iran CP 28 ng, other children in hospital 30 ng - 2018

Prevalence of Vitamin D Deficiency and Associated Risk Factors in Cerebral Palsy A study in North-West of Iran.
Iran J Child Neurol. 2018 Spring;12(2):25-32.
Toopchizadeh V1, Barzegar M2, Masoumi S1, Jahanjoo F1.

OBJECTIVE:
This study aimed to compare the prevalence of 25-hydroxyvitamin D deficiency in cerebral palsied (CP) with healthy control children and evaluate possible correlations between 25-hydroxyvitamin D and severity of CP and motor function.

MATERIALS & METHODS: In this case-control study, serum levels of 25-hydroxyvitamin D were evaluated in 65 children with CP and compared with 65 healthy children referred to Tabriz Pediatric Hospital, Tabriz, northwestern Iran in 2015. Blood samples were taken to measure levels of 25-hydroxyvitamin D, calcium, phosphorus and alkaline phosphatase. Regarding 25-hydroxyvitamin D levels, patients were classified as sufficient (≥30 ng/ml), insufficient (20-30 ng/ml) and deficient (<20 ng/ml).

RESULTS: Mean 25-hydroxyvitamin D levels were 28.03±24.2 ng/ml in patients and 30±1.94 ng/ml in control group. 25-hydroxyvitamin D deficiency was seen in 44.6% of CP and 18.5% of healthy children. There was no significant difference in 25-hydroxyvitamin D levels between boys and girls, CP types and use of antiepileptics in case group. There was significant negative correlation between age and 25-hydroxyvitamin D levels (P=0.007). The correlation between 25-hydroxyvitamin D and Gross Motor Function Classification System was not significant.

CONCLUSION: 25-hydroxyvitamin D deficiency is common in children with CP in comparison with healthy children. There was significant negative correlation between age and 25-hydroxyvitamin D levels. Routine measurement of 25-hydroxyvitamin D levels and its proper treatment is recommended to prevent its deficiency and subsequent consequences.

PMID: 29696043

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Cerebral Palsy, preterm birth, and Vitamin D        

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