Fetal Stroke and Neonatal Stroke: What You Need to Know

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Pregnancy is a delicate balance of hormones, nutrients, and overall health. As an expectant mother, you’ve likely immersed yourself in health education for you and your baby. One rare but potentially serious health threat you may not be familiar with is fetal stroke. So, what is fetal stroke and how can it affect you and your baby? Below, we’ll go over details about what causes a baby to have a fetal stroke and its associated dangers, preventing fetal stroke, and how you can get help if your baby’s fetal stroke was caused by a birth injury.

What is fetal stroke and how does it affect my baby?

Fetal stroke occurs in children before they are born — anytime between 14 weeks of gestation and labor. Fetal stroke is also referred to as cerebral infarction.

The complications of fetal stroke can be severe and lifelong. Cerebral palsy is one common outcome if a baby experiences a stroke in utero. Epilepsy, which may cause serious seizures, is another potential issue for babies who have endured a stroke in the womb. Finally, developmental delay may occur depending on the severity of the stroke.

Neonatal or perinatal stroke is a related issue that may occur in newborns up to 30 days after birth. These type of strokes, while extremely rare (affecting approximately 1 in 4,000 babies), can be very damaging. As rare as they are, strokes in children are more common than brain tumors, with 10% of children dying as a result of a stroke and another 50% of survivors are left with severe neurological and learning disabilities.

Aside from that scary news, the Children’s Hospital of Philadelphia has shared one of the biggest reasons to be concerned about infant stroke:

The average delay in diagnosis of a pediatric stroke is 28 hours. That’s a waste of precious time when every minute counts. Quick, proper treatment is critical to saving a child’s life, minimizing brain damage and lasting effects, and reducing the risk for another stroke.

So, time is of the absolute essence.

See also: Safe Delivery: How Doctors Can Avoid Birth Injuries

What causes a baby to have a stroke?

Similar to an adult experiencing a stroke, unborn babies suffer from a blockage of blood to the brain. Why would there be a blockage of blood to an unborn baby’s brain? One possibility is the formation of a blood clot within the baby’s blood vessels. Without a smooth flow of blood to the brain, a blockage may form, potentially resulting in a stroke.

Another cause of fetal stroke is hypoxic ischemic encephalopathy (HIE) which develops after oxygen deprivation to the unborn child’s brain. HIE is simultaneously a risk factor for fetal stroke and many times precedes the neurological episode. HIE often leads to brain damage that in turn causes cognitive delays. Motor functions in babies who have experienced HIE may also be impaired.

For babies who experience stroke during labor, birth trauma may be a contributing factor. Trauma is more likely to occur during breech births or any difficult labor. While moving through the birth canal, a baby’s nerves may be damaged through pressure to the cranium or facial muscles. Such trauma may lead to neonatal stroke.

As the baby’s brain is still developing in the womb, and will continue to develop for decades after birth, infant stroke frequently causes more serious complications than an adult would experience.

See also: Breech Presentation: Babies Born Backwards

Is infant stroke preventable?

In some cases, no. A full 50% of fetal strokes occur with no known risk factors and mothers should not feel they are to blame. The most common maternal conditions associated with fetal stroke are trauma and alloimmune thrombocytopenia, a disease in which the platelet count is decreased. While pregnant, it may be advised by your doctor to manage any potential issues by planning out your delivery and avoiding the consumption of certain medications, like aspirin and anti-inflammatory drugs.

While it may not be possible to eliminate the risk of fetal stroke, there are positive steps pregnant mothers can take to reduce the risk.

For example, high blood pressure (also called preeclampsia) in the mother has been identified as a possible cause of fetal stroke. Lifestyle changes may succeed in lowering blood pressure and guard against gestational diabetes. A low-sodium diet, for example, can naturally lower blood pressure. Cutting caffeine from the diet is another healthy step. Finally, participating in relaxing mind-body activities like prenatal yoga and Tai Chi may help stabilize blood pressure levels.

On the other hand, extremely low blood pressure is dangerous as well. Some causes of low blood pressure, such as heat exhaustion, are preventable. A good rule of thumb for expectant mothers is to stay away from extreme temperatures and avoid stress whenever possible. Again, a balanced lifestyle with proper nutrition and moderate exercise is advisable.

Certain infections the mother may harbor, like pelvic inflammatory disease (PID), have also been cited as risk factors for fetal stroke. Regular visits to your OB-GYN are the best way to prevent such infections or to effectively treat those that are already present. Women with a history of sexually transmitted disease may be at particularly high risk for PID and should consult with their physician for treatment options.

Seek Legal Help for Birth Trauma

While there are measures you can take to reduce the risk of infant stroke, there are no guarantees. If you’re taking care of yourself, then you’re also taking care of your baby. Being vigilant about keeping doctors’ appointments and leading a balanced lifestyle means you are doing your best.

If your baby has suffered from a fetal or neonatal stroke, there are resources designed to help you. If you suspect medical malpractice — for example, the most common reason for birth injuries are communication errors among the birthing team — seeking legal counsel may be the next logical step. Know that you are not alone and there are people who may be able to help.