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Mysteries surround infant brain damage.

Mysteries surround infant brain damage

When a baby is born with mental retardation or other neurological disorders, such as cerebral palsy or epilepsy, the question parents most often ask is "What caused it?' The answer, according to members of a panel on pre-and perinatal factors associated with brain disorders, most often is "We don't know.'

"For the vast majority of infants with these disorders, we can't find a single cause,' says panel chairman John Freeman of Johns Hopkins Hospital in Baltimore. "They may be due to metabolic, viral or genetic factors, rather than pre-or perinatal problems.'

The panel was convened in Washington, D.C., this week by the National Institute of Child Health and Human Development and the National Institute of Neurological and Communicative Disorders and Stroke. It concluded that, though few specific causes and effects have been identified, there are thresholds for neurological insults beyond which damage may result. For example, a fetus or infant can tolerate hypoxia, decreased blood flow to body tissues, up to a certain point, but beyond that point damage often results. Thresholds for damage also depend on the individual's own reserves and previous damage, as well as the postnatal environment.

Hugo Moser, president of the Baltimore-based John F. Kennedy Institute for Handicapped Children, found that prenatal factors, such as chromosomal abnormalities and viral infections, are important causes of severe mental retardation, whereas mild retardation is affected more by the postnatal environment.

For cerebral palsy, a motor dysfunction often accompanied by mental retardation, events during labor and delivery are more important risk factors than pre-and postnatal events, the panel says. Asphyxia-- both the inability of the infant to breathe and reduced oxygen supply to the brain-- is the most important cause, but the threshold beyond which it causes damage is not yet known, according to the panel.

The panel cited prematurity and low birthweight as the factors most highly correlated with neurological disorders. As highly technical intensive care is applied to such high-risk infants, physicians and health care workers face a sort of medical catch-22: If these infants survive, they are likely to have neurological problems, so should an attempt be made to save them?

Asked whether the panel's report would help clear obstetricians of some blame in childbirth malpractice suits, audience member and President of the American College of Obstetricians and Gynecologists Luella Klein answered yes. "It shows,' she says, "that most childhood neurological problems are not related to events during labor and delivery.'
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Author:Bennett, Dawn D.
Publication:Science News
Date:Apr 13, 1985
Words:410
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