Cerebral palsy

==Prevention==
Because the causes of CP are varied, a broad range of preventive interventions have been investigated.<ref name="Shepherd et al 2016" />

[[Electronic fetal monitoring]] has not helped to prevent CP, and in 2014 the [[American College of Obstetricians and Gynecologists]], the [[Royal Australian and New Zealand College of Obstetricians and Gynaecologists]], and the [[Society of Obstetricians and Gynaecologists of Canada]] have acknowledged that there are no long-term benefits of electronic fetal monitoring.<ref name="nejm915" /> Before this, electronic fetal monitoring was widely used to prop up obstetric litigation.<ref name="Sartwelle" />

In those at risk of an early delivery, [[magnesium sulphate]] appears to decrease the risk of cerebral palsy.<ref>{{cite journal | vauthors = Crowther CA, Middleton PF, Voysey M, Askie L, Duley L, Pryde PG, Marret S, Doyle LW | title = Assessing the neuroprotective benefits for babies of antenatal magnesium sulphate: An individual participant data meta-analysis | journal = PLOS Medicine | volume = 14 | issue = 10 | pages = e1002398 | date = October 2017 | pmid = 28976987 | pmc = 5627896 | doi = 10.1371/journal.pmed.1002398 | doi-access = free }}</ref> It is unclear if it helps those who are born at term.<ref name="Ngu2013" /> In those at high risk of preterm labor a review found that moderate to severe CP was reduced by the administration of magnesium sulphate, and that adverse effects on the babies from the magnesium sulphate were not significant. Mothers who received magnesium sulphate could experience side effects such as [[respiratory depression]] and nausea.<ref>{{cite journal | vauthors = Zeng X, Xue Y, Tian Q, Sun R, An R | title = Effects and Safety of Magnesium Sulfate on Neuroprotection: A Meta-analysis Based on PRISMA Guidelines | journal = Medicine | volume = 95 | issue = 1 | pages = e2451 | date = January 2016 | pmid = 26735551 | pmc = 4706271 | doi = 10.1097/MD.0000000000002451 }}</ref> However, guidelines for the use of magnesium sulfate in mothers at risk of preterm labour are not strongly adhered to;<ref name="pmid29319155" /> in 2017 only 2 in 3 eligible women in the UK received the medication despite it being recommended by [[National Institute for Health and Care Excellence|NICE guidelines]].<ref>{{Cite journal |last1=Edwards |first1=Hannah B |last2=Redaniel |first2=Maria Theresa |last3=Sillero-Rejon |first3=Carlos |last4=Margelyte |first4=Ruta |last5=Peters |first5=Tim J |last6=Tilling |first6=Kate |last7=Hollingworth |first7=William |last8=McLeod |first8=Hugh |last9=Craggs |first9=Pippa |last10=Hill |first10=Elizabeth |last11=Redwood |first11=Sabi |last12=Donovan |first12=Jenny |last13=Treloar |first13=Emma |last14=Wetz |first14=Ellie |last15=Swinscoe |first15=Natasha |date=July 2023 |title=National PReCePT Programme: a before-and-after evaluation of the implementation of a national quality improvement programme to increase the uptake of magnesium sulfate in preterm deliveries |journal=Archives of Disease in Childhood - Fetal and Neonatal Edition |language=en |volume=108 |issue=4 |pages=342–347 |doi=10.1136/archdischild-2022-324579 |pmid=36617442 |pmc=10314002 |issn=1359-2998}}</ref> An [[National Health Service|NHS]] quality improvement programme increased its usage in England from 71% in 2018 to 83% in 2020.<ref>{{Cite journal |last1=Edwards |first1=Hannah B |last2=Redaniel |first2=Maria Theresa |last3=Sillero-Rejon |first3=Carlos |last4=Margelyte |first4=Ruta |last5=Peters |first5=Tim J |last6=Tilling |first6=Kate |last7=Hollingworth |first7=William |last8=McLeod |first8=Hugh |last9=Craggs |first9=Pippa |last10=Hill |first10=Elizabeth |last11=Redwood |first11=Sabi |last12=Donovan |first12=Jenny |last13=Treloar |first13=Emma |last14=Wetz |first14=Ellie |last15=Swinscoe |first15=Natasha |date=July 2023 |title=National PReCePT Programme: a before-and-after evaluation of the implementation of a national quality improvement programme to increase the uptake of magnesium sulfate in preterm deliveries |journal=Archives of Disease in Childhood - Fetal and Neonatal Edition |language=en |volume=108 |issue=4 |pages=342–347 |doi=10.1136/archdischild-2022-324579 |pmid=36617442 |pmc=10314002 |issn=1359-2998}}</ref><ref>{{Cite journal |date=30 May 2023 |title=NHS quality improvement programme reduces the risk of cerebral palsy in newborns |url=https://evidence.nihr.ac.uk/alert/nhs-quality-improvement-programme-reduces-risk-cerebral-palsy-newborns/ |journal=NIHR Evidence|doi=10.3310/nihrevidence_58371 }}</ref>

[[Caffeine]] is used to treat [[apnea of prematurity]] and reduces the risk of cerebral palsy in premature babies, but there are also concerns of long term negative effects.<ref>{{cite journal | vauthors = Atik A, Harding R, De Matteo R, Kondos-Devcic D, Cheong J, Doyle LW, Tolcos M | title = Caffeine for apnea of prematurity: Effects on the developing brain | journal = Neurotoxicology | volume = 58 | pages = 94–102 | date = January 2017 | pmid = 27899304 | doi = 10.1016/j.neuro.2016.11.012 | s2cid = 46761491 }}</ref> A moderate quality level of evidence indicates that giving women [[antibiotic]]s during preterm labor before her membranes have ruptured (water is not yet not broken) may increase the risk of cerebral palsy for the child.<ref name="pmid28786098" /> Additionally, for preterm babies for whom there is a chance of fetal compromise, allowing the birth to proceed rather than trying to [[Tocolytic|delay the birth]] may lead to an increased risk of cerebral palsy in the child.<ref name="pmid28786098" /> [[Corticosteroids]] are sometimes taken by pregnant women expecting a preterm birth to provide neuroprotection to their baby.<ref>{{cite journal | vauthors = Chang E | title = Preterm birth and the role of neuroprotection | journal = BMJ | volume = 350 | pages = g6661 | date = January 2015 | pmid = 25646630 | doi = 10.1136/bmj.g6661 | s2cid = 46429378 }}</ref> Taking corticosteroids during pregnancy is shown to have no significant correlation with developing cerebral palsy in preterm births.<ref name="pmid28786098" />

Cooling high-risk full-term babies shortly after birth may reduce disability,<ref name="jacobs_2013" /> but this may only be useful for some forms of the brain damage that causes CP.<ref name="research gaps 2016" />