Causal pathways to cerebral palsy

Abstract 

Cerebral palsy is a heterogeneous collection of diseases with diverse causes. Its frequency is not declining. Current preventive strategies need supplementing. A causal pathway is a network of factors, each necessary for the disease to develop by this route, so that avoiding any one causal factor prevents the disease occurring. The concept of causal pathways facilitates the identification of distal causal factors and understanding the conditions under which a factor can constitute a cause, thereby increasing the choice of preventive strategies enabling the most effective, available and acceptable to be chosen. Causal pathway analysis is complicated by risk factors that lie on more than one path, are imprecisely or variably defined or act in a variety of ways. Evaluation requires that interventions be followed to an age at which cerebral palsy can be reliably recognized.

Keywords: cerebral palsy, aetiology, risk factors, causal factors, causal pathways, prevention

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• f1 Correspondence to: EB. TVW Telethon Institute for Child Health Research, PO Box 855, West Perth, WA 6872, Australia. Tel.: +61 618 9489 7757; Fax: +61 618 9489 7700; E-mail: eve@ichr.uwa.edu.au