Antecedents of cerebral palsy in very low-birth weight infants

The pathogenesis of cerebral palsy seems to involve factors operating both during pregnancy and in the neonatal period. The most important prenatal fa ctor appears to be intrauterine infection. This and other factors, such as the death of a co-twin, placental abruption, and cerebral ischemia, may tri gger a cytokine cascade, resulting in damage to the developing brain. Block ade of the proinflammatory cascade, or promotion of endogenous inhibitors, might prevent cerebral palsy. Other potentially preventive strategies inclu de corticosteroids given to mothers (but not those given to neonates) and t hyroid hormone.