Introduction:
Neonatal strokes can have severe and long-lasting consequences, including cerebral palsy and mortality. While birth trauma has often been associated with neonatal strokes, recent studies challenge this assumption. This blog post aims to summarize two studies—one from 2021 and a more exhaustive one from 2018—that shed light on the relationship between birth trauma and neonatal strokes.
Study 1 (2021):
The 2021 study, conducted in Southern Alberta, Canada, analyzed data from registries to investigate the link between birth trauma and neonatal stroke. The researchers compared cases of neonatal arterial ischemic stroke (NAIS), hemorrhagic stroke (NHS), and hypoxic-ischemic encephalopathy (HIE) with MRI-confirmed injury to a control group without injury. The study found no empirical evidence supporting an association between birth trauma and neonatal stroke. Scalp trauma scores did not significantly differ between groups and were not linked to stroke outcomes. These findings challenge the misconception and call for a reconsideration of the term “birth trauma” to provide accurate counseling for parents and advance understanding of the true causes of neonatal stroke.
Study 2 (2018):
The 2018 study provided a more comprehensive overview of birth injury, including birth asphyxia and birth trauma. Birth trauma refers to mechanical injuries sustained by the fetus or newborn during labor and delivery. Birth asphyxia, on the other hand, results from insufficient oxygen exchange during delivery, leading to hypoxia, ischemia, and potential organ damage. Birth asphyxia can cause hypoxic-ischemic encephalopathy (HIE), resulting in cognitive and physical disabilities, seizures, and cerebral palsy.
Discussion
While birth trauma can contribute to neonatal strokes in some cases, it is not the sole cause. Neonatal strokes can have various origins, and their classification includes arterial ischemic stroke (AIS) and hemorrhagic stroke. Multiple factors can contribute to neonatal strokes, such as pre-existing conditions (e.g., maternal infections, genetic disorders), birth-related factors (e.g., birth asphyxia, placental abnormalities), and postnatal factors (e.g., infections, medical conditions).
It is important to note that determining the exact cause of neonatal strokes can be challenging, and each case requires a thorough evaluation by medical professionals specializing in neonatal neurology.
Conclusion:
Birth trauma is not the exclusive cause of neonatal strokes. However, it can be a contributing factor in some cases, or a sole cause in others. Other factors such as pre-existing conditions and postnatal factors may also play a role. The accurate diagnosis and evaluation of neonatal strokes necessitate a comprehensive assessment by healthcare providers with expertise in neonatal neurology. Understanding the multifactorial nature of neonatal strokes is crucial for providing accurate information and support to parents and advancing research in this field.
Sources:
https://www.ahajournals.org/doi/10.1161/str.52.suppl_1.P581
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491540/