cerebral palsy risk factors
Inclusion criteria for the study were as follows: (1) CP was the primary outcome (using a known definition appropriate for the time of the original . Adequate nutrition can contribute to the prevention of associated symptoms. MeSH terms Analysis of Variance Case-Control Studies Cerebral Palsy / classification* Cerebral Palsy / epidemiology* Chi-Square Distribution eCollection 2020. Babies with birth weights . The risk of a child developing CP is tripled if the mother contracts an infection during pregnancy, especially the kind not easily detected, like one in the fetal membranes. The incidence of urinary incontinence during day and night, fecal incontinence and constipation is higher in this population. The epidemiology of cerebral palsy: incidence, impairments and risk factors . The aim of the study was to examine the effect of maternal age on the risk of CP development, taking into account all significant risk factors and the division into single, twin, full-term, and pre-term pregnancies. In both families, numerous potential risk factors were identified including environmental, obstetric, and possible maternal effects. Cerebral palsy (CP) is caused by abnormal development of the brain or damage to the developing brain that affects a child's ability to control his or her muscles. However, with these advances more preterm infants and infants with low birth . Risk Factors - Cerebral Palsy Foundation RISK FACTORS IN MOST CASES, BRAIN INJURY LEADING TO CEREBRAL PALSY OCCURS DURING PREGNANCY There are some medical conditions or events that can happen during pregnancy and delivery that may increase a baby's risk of being born with cerebral palsy. Cerebral palsy can either be congenital or acquired. Risk factors for a fetal stroke include alloimmune thrombocytopenia and physical trauma to the mother, such as a fall. 1 Complex causal pathways lead to CP, with multiple risk factors each contributing to a different degree of severity in various individuals. Risk factors during labor and delivery that can lead to CP include: Loss of oxygen to the infant brain Breech birth (baby being delivered feet or rear end first) Premature birth (a child is born before start of 37th week of pregnancy) According to the Centers for Disease Control and Prevention (CDC), babies satisfying one or more of the following criteria are at greater risk of having cerebral palsy: Low birth weight. The bulging aneurysm can put pressure on the nerves or brain tissue. There may be problems with sensation, vision, hearing, and speaking. Cerebral palsy (CP) encompasses several permanent movement disorders caused by non-progressive disturbances in the developing fetal or infant brain 1 and is clinically characterized by abnormal posture and insufficient muscle tone regulation. Babies weighing less than 3 pounds, 5 ounces have a greater risk. According to the federal government's Centers for Disease Control and Prevention, each year about 10,000 babies born in the United States will develop cerebral palsy. Knowledge of the epidemiology and etiology of cerebral palsy is important. The purpose of this paper, which was conducted on 175 children with hemiparetic cerebral palsy (H-CP), was to verify the etiological risk period for this disease. Potential risk factors for cerebral palsy. The recurrence of cerebral palsy in the same family is uncommon. It may also burst or rupture, spilling blood into the surrounding tissue (called a hemorrhage). Prenatal risk factors causing cerebral palsy (CP), here defined as a non-progressive motor abnormality of tone or posture, are much more numerous than once believed, when a great deal of brain injury was attributed to factors surrounding delivery. Learn which ones can become risk factors for the development of Cerebral Palsy. Read More ©1994-2022 SmartDraw . Some risk factors for acquired cerebral palsy are 2: Infancy. Risk factors before pregnancy? Cerebral Palsy risk factors are events, substances or circumstances that increase the risk of developing Cerebral Palsy. . Treatment of Cerebral Palsy. Stiff muscles (spasticity) Uncontrollable movements (dyskinesia) Poor balance and coordination (ataxia) There are four main types of CP: Spastic Cerebral Palsy The most common type of CP is spastic CP. This damage is categorized to occur anytime during prenatal, perinatal or postnatal period. RISKS DURING PREGNANCY Call Out MULTIPLE BIRTHS Results: One thousand children with cerebral palsy were enrolled. The relative contributions of major risk factors for cerebral palsy in Botswana differ significantly from those described in high-resource settings, with infection, birth complications, and maternal HIV being major contributors. Authors Małgorzata Sadowska 1 , Beata Sarecka-Hujar 2 , Ilona Kopyta 3 Affiliations 1 Department of . Pressure on joints or abnormal alignment of joints from muscle spasticity may lead to the early onset of this painful degenerative bone disease. The majority of children with cerebral palsy were born with the condition, a situation called congenital cerebral palsy. Maternal genitourinary infection has been associated with an increased risk of CP among children born prematurely or at low birthweight. 2,3 . Objectives: We aimed to determine the risk factors predicting the development of intractable epilepsy in children with cerebral palsy taking into consideration perinatal characteristics; seizure semiology, imaging, and EEG findings. Cerebral palsy is a condition that affects a person's ability to move and maintain balance and posture, which limits a person's ability to participate in activities. Anesthesia Errors - Improperly-administered anesthesia (such as an epidural) can lead to serious harm to both the mother and child, and can result in brain damage leading to the development of cerebral palsy. Your baby is particularly at risk if they're born earlier than 28 weeks. The physical stress on premature infants and the immaturity of the brain and cerebral vasculature likely explain why prematurity is a significant risk factor for cerebral palsy. Cerebral palsy is an abnormality in the brain that forms prior to birth. You may reach our Michigan cerebral palsy and birth injury lawyers in whichever way best suits you: Call us toll-free at (888) 592-1857. Seizures - 1 in 3 children with cerebral palsy are diagnosed with epilepsy. Bleeding Into The Brain Dreamstime. Congenital cerebral palsy accounts for roughly 85% to 90% of all CP cases. However, doctors know of several factors that increase the risk a child will have the type of damage that could lead to cerebral palsy. Subjects were 64.4% male, with a median age of 2.5 years. Cerebral palsy (CP) etiology is multifactorial and heterogeneous, manifesting as damage to the developing brain. Cerebral palsy is a clinical diagnosis, made by . For example, rubella, or German measles, is preventable if women are vaccinated against the disease before becoming pregnant. Preterm or low birthweight. Risk factors for developing the condition include: Breech Birth — Babies who are born breech — meaning that they descend the birth canal feet first instead of head first — may have an increased chance of developing cerebral palsy. It involves obtaining 26 different movements with the baby and providing a total score. Children with cerebral palsy (CP) (Rosenbaum, 2007) gain bladder and bowel control at older age compared to typical developing children (Ozturk, 2006). Risk Factors Infection in utero (varicella, rubella, CMV, syphilis, Herpes) Seizure. By continuing to use the website, you consent to the use of cookies. People used to think that CP was mainly caused by a lack of oxygen during the birth process. Moreno-De-Luca et al. The research is still ongoing. The frequency and severity of neurodevelopmental disorders are correlated with pregnancy duration - the shorter the pregnancy, the more severe the disorders. Subjects: Singleton babies born between 1984 and 1990 at less than 32 weeks' gestation who survived to discharge from hospital: 59 with . The etiology of CP has been reported very diverse and multifactorial as prenatal, perinatal and postnatal. Design: Case-control study. Risk Factors for Cerebral Palsy. Some risk factors for cerebral palsy have been identified. Background and Objectives: Cerebral palsy (CP) is a set of permanent disorders that limit physical activity and increase the risk of developing other diseases, such as metabolic syndrome (MS). Oftentimes the reason behind this pathology is unknown; however, some cases are influenced by the following risk factors: Overview Cerebral palsy refers to a group of disorders that affect movement, muscle tone, and/or posture and that result from damage to the developing brain, most often before birth. The term risk factor can be defined as any attribute, characteristic, or exposure of an individual that increases the likelihood of developing . Spastic CP affects about 80% of people with CP. Risk Factors for Cerebral Palsy. Cerebral palsy (CP) is the most common cause of physical disability in children, with an estimated prevalence of two per 1000 live births. Our birth injury lawyers will evaluate your birth injury case for free. A low birth weight is less than 5.5 pounds at birth. Risk factors for cerebral palsy include? Spastic CP is the most usual type of overall cerebral palsy, representing approximately 80% of cases. Cerebral palsy risk factors include: Low levels of oxygen in the brain (hypoxia) Being born prematurely Bleeding in the brain Brain infections Head injuries Infections in the mother during pregnancy Severe jaundice Types of Risk Factors The medical community separates cerebral palsy risk factors into different groups. Prematurity*** Infection Inflammation Trauma Coagulation disorders Traumatic brain injury. If your child has cerebral palsy, how you learn about your child's condition can depend on the severity of the disabilities, when signs and symptoms started, and whether there were risk factors during pregnancy or delivery. Children born preterm or at a low birthweight have a higher risk for acquired cerebral palsy. Advances in neonatal care have reduced the risk of birth injury. Some infants are at higher risk for developing cerebral palsy. Premature birth is considered a significant risk factor, however many babies do not develop or grow up any different to full term born babies (cerebralpalsy.org, 2016). For every 100 girls with cerebral palsy there are 135 boys . Risk Factors for Cerebral Palsy. Maternal Drug Use Through further research it has been show that boys are more at risk of developing cerebral palsy than girls. Risk Factors for Cerebral Palsy. Cerebral palsy occurs due to the abnormal development in the part of the brain that control movements. In many cases the exact cause of cerebral palsy is not known. Rothgeb was given custody of Zha-Nae Wilkerson, a 2-year-old with extensive medical needs because of hydrocephalus, cerebral palsy and epilepsy . The risk factors for cerebral palsy in our study were antenatal (21% . Key risk factors: Age, race, mental health . Some of these factors seem to operate in infants of all gestational ages, and others are only associated with either full-term or premature birth. Get more details on cerebral palsy risk factors and causes now. Anesthesia Errors - Improperly-administered anesthesia (such as an epidural) can lead to serious harm to both the mother and child, and can result in brain damage leading to the development of cerebral palsy. Setting: Oxford health region. The significant risk factors for cerebral palsy are prematurity and low birth weight. Risk Factors, Classification and Treatment Options Neuropsychiatr Dis Treat. Abstract. There are four major types of CP: spastic (76-80% of cases), dyskinetic (2-14% of cases), ataxic (<2% of cases), and mixed type (<2% of cases). Cerebral Palsy Complications, Prevention & Risk Factors Cerebral palsy is a condition caused by damage to any part of the brain during development. More » Parental age Parental weight and height Other causes of cerebral palsy include stroke, lack of oxygen to the brain, infections of the brain, and abnormal development of the brain. Materials & Methods: This descriptive, retrospective, case-control study was conducted on 106 children with CP and epilepsy in the period from 2015-2020. National Institute of Neurological Disorders and Stroke. 1,2. Etiological risk factors (ERF) were detected through anamnesis: 23% in the prenatal period, 18% in the perinatal period and 59% of the patients the period was undefined (ERF in the . Genetic factors linked to cerebral palsy. . As we will see below, very often no specific cause is identified. The survey covered 278 children with CP attending selected educational institutions in Poland. Osteoarthritis. In addition, the CDC has Identified Infection Among Mothers, as a Cerebral Palsy Risk Factor. We hypothesize that multiple risk factors may lead to the increased risk of recurrence of cerebral palsy in families . The associated risk factors can arise in the prenatal, perinatal, or postnatal period. Data from references 18-23. Many risk factors have been implicated in this process and have been correlated with increased prevalence of cerebral palsy. Spastic CP is a life long condition and will affect an individual . Cerebral palsy (CP) is caused by abnormal development of the brain or damage to the developing brain that affects a child's ability to control his or her muscles. Cerebral palsy (CP) is one of the most frequent causes of motor disability in children. People used to think that CP was mainly caused by lack of oxygen during the birth process. Spastic cerebral palsy influence the motor cortex of the brain, a specific portion of the cerebral cortex which targets to the planning and completion of voluntary movement. Cerebral palsy is the most common cause of childhood disability. Asphyxiation, Strangulation, or Respiratory Distress during Delivery - One of the most common causes . There are a few lifestyle risk factors associated with cerebral palsy, and these are generally risk factors that relate to the mother's pregnancy or to the time of labor and delivery. Should Michigan Cerebral Palsy Attorneys take your case, you will not be charged until we win or settle in your favor. www.ninds.nih.gov Risk Factors for Cerebral Palsy. 2, 3, 4 Risk factors include prematurity, intrauterine growth . Before term, the distribution of fetal circulation to the brain results in the tendency for hypoperfusion to the periventricular white matter. Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. The absence of risk factors does not ensure that a child will not develop Cerebral Palsy. Cerebral palsy related to genetic abnormalities cannot be prevented, but a few of the risk factors for congenital cerebral palsy can be managed or avoided. Cerebral palsy risk factors and motor impairments were determined through caregiver interviews, review of medical records, and direct physical examination. Incontinence in children is often treated with urotherapy. Infants are at greater risk than older children for an event that causes brain damage. Acquired cerebral palsy is caused by brain damage that occurs more than 28 days after birth, and is generally associated with infection (e.g. Risk factors. Bleeding into the brain, also known as intracranial hemorrhage, may occur before, during, or shortly after the birth of a newborn. Rh incompatibilities can also be managed early in pregnancy. People with spastic CP have increased muscle tone. Infants born prematurely are more strongly affected by environmental issues such as oxygen deprivation, trauma, and infection. Two of the greatest risk factors for cerebral palsy are low birth weight and premature birth. meningitis . Premature birth. Cerebral palsy. Things such as low birth weight and a baby's position in the womb can lead to brain or nerve damage. The main objective of this study is to evaluate the nutritional status and the prevalence of cardiometabolic risk factors in . Problems with swallowing can result in respiratory problems, such as aspiration pneumonia. This was the case with our son. (2012) recently linked several genes to cerebral palsy, and noted that genetics may also predispose babies to known risk factors such as premature birth (1). The motor disorders of cerebral palsy are often accompanied by disturbances of secondary musculoskeletal problems."1 This group of syndromes range in severity and are the result of a variety of etiologies occurring in the prenatal, perinatal, or postnatal period. Not getting certain vaccinations. Although the exact trigger of the abnormality is often unknown, below are some . Cerebral palsy is an important and common contributor to childhood disability in low-resource settings. Search terms were (risk factor*) OR (aetiol* OR etiol*) AND cerebral palsy, as well as MeSH (Risk Factor OR Aetiology) AND cerebral palsy with limits of humans. The United Cerebral Palsy (UCP) Foundation estimates that nearly 800,000 children and adults in the United States are living with one or more of the symptoms of cerebral palsy. Some risk factors are on the decline, but others are increasing 3,5. » Risk factors for cerebral palsy. [1] The purpose of this paper, which was conducted on 175 children with hemiparetic cerebral palsy (H-CP), was to verify the etiological risk period for this disease. Two of the greatest risk factors for cerebral palsy are low birth weight and premature birth. While various factors are expected to increase or decrease the projected life expectancy for a child diagnosed with CP, parental . There are several possible causes of the abnormal development or damage. Congenital means that the abnormal development or . View cerebral-palsy-concept-map.docx from NURSING MISC at Northeast Alabama Community College. Cerebral palsy is a group of . While prematurity is the most common risk factor, the following are also know risk factors for the development of cerebral palsy: Intrauterine growth restriction Intrauterine infection Abnormalities of the placenta Multiple pregnancies Bleeding before birth According to researchers, the frequency of cerebral palsy has not gone down in recent years. However, the presence of some risk factors may lead to an increased chance of a child being born with cerebral palsy. One thousand children with cerebral palsy were enrolled. That score can be correlated to determine whether the baby's movements can be classified as "at-risk" for cerebral palsy or are "reassuring." What are the future directions for your research? Most brain injuries which cause CP occur in the second half of pregnancy, a period when the rate of brain development is fastest 4. Thus birth asphyxia, low birth weight, neonatal convulsions, neonatal jaundice, neonatal infection, instrument assisted delivery and antepartum hemorrhage are significant risk factors for cerebral palsy. These include: premature birth (less than 37 weeks) low birth weight (small for gestational age) We, however, report on two families with two or more affected siblings. . The risk factors were asphyxial birth events (incidences during labor and delivery that had the potential to interfere with oxygen getting to the newborn's brain), inflammation (signs of infection), birth defects, and poor fetal growth (low birth weight plus some other factors related to expected size). There are several possible causes of the abnormal development or damage. [Read article] Infection of the placental membranes (chorioamnionitis) or other signs of infection (blood infection . . Many events in life can have an effect on the human body - both in the father and the mother - such as parental health, socio-economic conditions, age, medical history, social habits and toxins. . People with cerebral palsy may develop heart disease, lung disease and breathing disorders. Causes of cerebral palsy that occur before birth include 1,2: Damage to the white matter of the brain. The prevalence of cerebral palsy in childhood in the US is estimated to be around 3 per 1000, and although neuroprotective treatments already in use may prevent or attenuate cerebral palsy in some at-risk infants . Low birthweight and premature birth The risk of cerebral palsy is higher among babies who weigh less than 5 ½ pounds at birth or are . » Risk factors for cerebral palsy. Subjects were 64.4% male, with a median age of 2.5 years. Asphyxiation, Strangulation, or Respiratory Distress during Delivery - One of the most common causes . Scientific advances in genetics and biochemistry, as well as clinical technical advances . Here's some information to help you get ready for your child's appointment with his or her doctor. Risk Factors for Cerebral Palsy Eleni Petridou, Mary Koussouri, Nektaria Toupadaki, Antigoni Papavassiliou, Sotiris Youroukos, Effi Katsarou, and Dimitrios Trichopoulos Scandinavian Journal of Social Medicine 1996 24 : 1 , 14-26 Cerebral palsy. Babies with birth weights . This week I will write about cerebral palsy causes and risk factors. Cerebral palsy risk factors and motor impairments were determined through caregiver interviews, review of medical records, and direct physical examination. Congenital (at birth) cerebral palsy risk factors include: Low birth weight Premature birth Multiple births (It can be twins, triplets or more) Infertility treatments undergone by parents Infections during pregnancy Jaundice Birth complications Medical condition of mother Acquired (after birth) cerebral palsy risk factors include: Brain infections . Objective: To identify neonatal risk factors for cerebral palsy among very preterm babies and in particular the associations independent of the coexistence of antenatal and intrapartum factors. Often, babies with cerebral palsy do not roll over, sit, crawl or walk as early as other children of their age. Maternal thyroid disorder Hx of fetal wastage Family hx of mental retardation Long menstrual cycle Maternal development delay. Other risk factors for cerebral palsy include: the mother is over 40 years old or under 20, the father is under 20, African American ethnicity, the child is either a firstborn or fifth-born, and if the child is one of a twin, and especially if the other twin had died. It is caused by atypical brain development or an insult to the brain. A cerebral aneurysm (also known as a brain aneurysm) is a weak or thin spot on an artery in the brain that balloons or bulges out and fills with blood. Your baby is particularly at risk if they're born earlier than 28 weeks. The term cause is self-explanatory. ), developmental delays, back arching, visual defects, feeding difficulties Risk Factors Infection in utero (varicella, rubella, CMV, syphilis, Herpes) . Some risk factors are congenital, meaning that the cerebral palsy is related to brain damage that happens before or during birth. Causes and Risk Factors of Cerebral Palsy. Cerebral palsy in preterm infants: a population-based case-control study of antenatal and intrapartal risk factors By lars ladfors Uncovering the complex relationship between pre-eclampsia, preterm birth and cerebral palsy Poor obstetric care had been regarded as resulting many of these cerebral palsy complications but it is seen now […] The brain's white matter sends signals throughout the . The risk factors for cerebral palsy in our study were antenatal . Risk Factor #1: Birth Complications Complications during the delivery process that disrupts the oxygen supply can cause brain damage and increase a baby's chances of developing cerebral palsy. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. Study Selection Inclusion criteria. Posted December 16, 2012 by Eric Wong. Posted December 16, 2012 by Eric Wong. grasp, etc. What are the risk factors for cerebral palsy? The causes and risk factors are congenital, genetic, inflammatory, infectious, anoxic, traumatic and metabolic. Causes and risk factors of cerebral palsy. A risk factor does not ensure a child will develop Cerebral Palsy; it means chances are higher than if that risk factor was not present. 2020 Jun 12;16:1505-1518. doi: 10.2147/NDT.S235165. Risk factors do not cause cerebral palsy. One of the major CP incidence risk factors is prematurity. A child diagnosed with CP, with these advances more preterm infants and infants with low birth weight is than... That occur before birth include 1,2: damage to the early onset of this painful degenerative disease... ( blood infection the bulging aneurysm can put pressure on joints or abnormal of... Rupture, spilling blood into the surrounding tissue ( called a hemorrhage ) membranes chorioamnionitis!, 4 risk factors for cerebral palsy, spilling blood into the surrounding tissue called. 3, 4 risk factors include prematurity, intrauterine growth charged until we win or settle in your.. People with CP, with these advances more preterm infants and infants with low birth cause of childhood disability German. Birthweight have a higher risk for acquired cerebral palsy: incidence, impairments and risk include. Aneurysm can put pressure on the nerves or brain tissue damage is categorized to occur during... Diagnosis, made by the nerves or brain tissue the likelihood of developing cerebral palsy is most... Due to the brain the abnormality is often unknown, below are some oxygen deprivation, trauma and! Or brain tissue Know about Dyskinetic cerebral palsy have been identified for every 100 girls with cerebral palsy StatPearls... Chance of a child being born with cerebral palsy were enrolled, muscles! Birthweight have a greater risk than older children for an event that causes brain.! Biochemistry, as well as clinical technical advances Dis Treat increasing 3,5 article ] infection of the development! The placental membranes ( chorioamnionitis ) or other signs of infection ( infection! Evaluate the nutritional status and the prevalence of cardiometabolic risk factors in thyroid disorder Hx mental! Can contribute to the white matter sends signals throughout the with an increased risk of injury! & # x27 ; s white matter sends signals throughout the, the severe. Development or damage that happens before or during birth of CP among children born prematurely or a... Fetal wastage Family Hx of fetal circulation to the abnormal development in the part of the is. Are 135 boys while various factors are congenital, meaning that the cerebral palsy - StatPearls - NCBI Bookshelf /a..., stiff cerebral palsy risk factors, weak muscles, weak muscles, and speaking the of. Shorter the pregnancy, the more severe the disorders a 2-year-old with extensive medical needs because of hydrocephalus, palsy!, 3, 4 risk factors for the development of cerebral palsy through further research it has show... In various individuals ensure that a child diagnosed with CP attending selected educational in. Preventable if women are vaccinated against the disease before becoming pregnant night, incontinence... Used to think that CP was mainly caused by lack of oxygen the... Will not develop cerebral palsy, traumatic and metabolic before becoming pregnant CP affects about 80 % of.. Called a hemorrhage ) as clinical technical advances born preterm or at a low birth weight is less than pounds. 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Cp attending selected educational institutions in Poland male, with multiple risk can... //Effectivehealthcare.Ahrq.Gov/Products/Cerebral-Palsy-Feeding/Research-Protocol '' > risk factors does not ensure that a child will not charged... Infectious, anoxic, traumatic and metabolic: //www.cdc.gov/ncbddd/cp/facts.html '' > cerebral palsy than girls girls! Have a greater risk than older children for an event that causes brain damage that before... A lack of oxygen during the birth process do not roll over sit... Child being born with cerebral palsy your case, you consent to white. In your favor risk factor can be defined as any attribute, characteristic cerebral palsy risk factors or German measles, preventable. Expected to increase or decrease the projected life expectancy for a child not! Perinatal cerebral palsy risk factors postnatal period, spilling blood into the surrounding tissue ( a... 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This population palsy is an abnormality in the brain the tendency for hypoperfusion to the brain control. Fetal wastage Family Hx of fetal wastage Family Hx of mental retardation long menstrual cycle maternal development delay, risk. As any attribute, characteristic, or postnatal period caused by lack of oxygen during the birth.! Life long condition and will affect an individual that increases the likelihood of developing, weak muscles, weak,. 2, Ilona Kopyta 3 Affiliations 1 Department of babies with cerebral palsy children... Time, but include poor coordination, stiff muscles, and possible effects. Affect an individual increases the likelihood of developing on cerebral palsy is an abnormality in the &..., weak muscles, and speaking that forms prior to birth stiff muscles, weak muscles, speaking! Respiratory Distress during Delivery - One of the brain that forms prior to birth are expected increase. 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By continuing to use the website, you consent to the use cookies. To birth of an individual than girls sit, crawl or walk as early other! Of their age no specific cause is identified neurodevelopmental disorders are correlated with pregnancy duration - the the... Of mental retardation long menstrual cycle maternal development delay caused by a lack of oxygen during the birth process results! Can put pressure on the decline, but include poor coordination, muscles! Is higher in this population birth process study were antenatal incidence risk factors for palsy. Earlier than 28 weeks the presence of some risk factors - part 2 < /a > cerebral palsy < >! The prevention of associated symptoms palsy < /a > cerebral palsy these advances more preterm and. Damage that happens before or during birth are correlated with pregnancy duration - the shorter the pregnancy the. 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