New guidelines for ascertaining the relation between childbirth and cerebral palsy

October 15, 1999

A template for defining a causal relation between acute intrapartum events and cerebral palsy: international consensus statement

Only a minor part of cerebral palsy cases begin in labour

This week's BMJ contains an international consensus statement on what is known about the causal relation between acute events during childbirth and cerebral palsy. The statement is supported by leading obstetric and midwifery organisations from around the world*. It has been prepared, say the authors, to help the public, healthcare workers, researchers and, where necessary, courts of law to understand the probability of whether, in any particular case, there is convincing evidence to suggest that the cerebral palsy was caused by events during labour and whether these were reasonably preventable.

Professor Alastair MacLennan, representing the International Cerebral Palsy Task Force writes that recent research strongly suggests that the large majority of neurological pathologies causing cerebral palsy occur as a result of many unpreventable factors, which occur either during fetal development or during the first four weeks of life.

In a linked editorial, Professor Leiv Bakketeig from Odense University in Denmark writes that research on the cause of cerebral palsy needs to focus more on antenatal events along with detailed follow up of newborn babies. In the near future, however, without proper surveillance and new insights, in most cases of cerebral palsy there will be nothing or nobody to blame, claims the author. Focus should therefore be on the provision of optimal care for infants with cerebral palsy and their families, he concludes.

Professor Alastair MacLennan, Department of Obstetrics and Gynaecology, University of Adelaide Women's and Children's Hospital, North Adelaide, Australia


Dr Ian McKenzie, John Radcliffe Hospital, Oxford

Professor Leiv Bakketeig, Institute of Public Health, Odense University, Denmark


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