By Sade Oguntola
There are actions people can take before and during pregnancy, as well as after birth that might help reduce the risk of developmental problems, including cerebral palsy. A number of studies have found that regular doses of folic acids can reduce the risk of having a premature baby by 70 percent.
Now, a programme to increase the use of magnesium sulfate, says it is an inexpensive but effective injection that helps prevent cerebral palsy in premature babies. Tagged prevention of cerebral palsy in preterm labour (PReCePT) project, led by researchers at the University of Bristol, and published in the Archives of Disease in Childhood.
Any baby born below 34 weeks is a premature baby. For example, the brain, lungs, and liver need the final weeks of pregnancy to fully develop. So, premature babies are more likely to have long-term health issues than are full-term infants. Illnesses like asthma and feeding problems are more likely to develop or linger. Premature children also are at higher risk of sudden infant death syndrome (SIDS).
Cerebral palsy is caused by abnormal development of the brain or damage to the developing brain that affects a child’s ability to control his or her muscles. This can happen before birth, during birth, within a month after birth, or during the first years of a child’s life, while the brain is still developing.
There are several possible causes of the abnormal development or damage. People used to think that cerebral palsy was mainly caused by lack of oxygen during the birth process. But scientists now think that this causes only a small number of cerebral palsy cases.
Now, evidence shows that babies can be protected from brain injury by giving magnesium sulfate to women who are at risk of premature birth. This can reduce the risk of cerebral palsy by a third. However, in many countries, not all eligible women were being given magnesium sulfate.
The PReCePT approach was developed in the West of England in 2014. It was led by the West of England Academic Health Science Network (AHSN) and University Hospitals Bristol and Weston NHS Foundation Trust.
It was then piloted in five NHS trusts in the West of England, and this pilot was evaluated by the NIHR Applied Research Collaboration West (NIHR ARC West). It has since been rolled out across England via the AHSN Network as a national programme.
The researchers also estimated that the programme’s first year could be associated with a lifetime saving to society of £3 million. This accounts for the costs of the programme, administering the treatment of cerebral palsy to society over a lifetime, and the associated health gains of avoiding cases. This is across all the extra babies the programme helped get access to the treatment during the first year.
Professor Chris Aimakhwu, a consultant psychiatrist at the University College Hospital (UCH) Ibadan, said of the findings “If you have a woman who is going into labour prematurely, magnesium sulphate will help stop the contraction that is the way it works. It is not that it has any effect directly on the brain of the baby.”
“It is just that magnesium sulphate is more effective and it is in the category of drugs that can help. It just stops the woman from delivering early. That is the role it plays. Any baby born below 34 weeks is a premature baby.”
Professor Aimakhwu declared that a lot of pregnant women can go into early delivery for many reasons and this could happen in women with fibroid in pregnancy or even infections like malaria and urinary tract infection.
“Once she starts to contract, if you don’t stop it, the contraction will lead to the opening of the cervix and the baby will come out.”
However, he declared that not all women are eligible to take the magnesium sulphate injection.
“At UCH, Ibadan, we use it. Of course, usually we categorise our patients or women. Sometimes, you can get away with using something much simpler because the magnesium sulphate has its own side effects like reduced urine output. Also, Magnesium sulfate toxicity can lead to respiratory depression or arrest.”
Some things increase the chance that a child will have cerebral palsy. Many babies are born with cerebral palsy because they have a low birth weight, infections like chickenpox and rubella in pregnancy, jaundice in the newborn, and problems with the umbilical cord during birth and medical conditions like thyroid problems, intellectual disability, or seizures in the mother.
Twins, triplets, and other multiple births have a higher risk for cerebral palsy, especially if a baby’s twin or triplet dies before birth or shortly after birth. Some, but not all of this increased risk is due to the fact that children born from multiple pregnancies often are born early or with low birth weight, or both.
Taking steps to help ensure a healthy pregnancy can help prevent developmental problems, including cerebral palsy. These include being as healthy as possible before pregnancy, vaccination for certain diseases (such as chickenpox and rubella) that could harm a developing baby and early and regular prenatal care.
Talk to the doctor about ways to prevent problems if at risk for preterm delivery. Research has shown that taking magnesium sulfate before anticipated early preterm birth reduces the risk of CP among surviving infants.
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