How Adelaide’s myth-busting science changed cerebral palsy

Homegrown research from Adelaide continues to play a major role in changing the world’s understanding of cerebral palsy, tracing the causes back to genetics and reducing costly litigations against obstetricians.

Leading Adelaide University cerebral palsy researcher, Emeritus Professor Alastair MacLennan AO, has spent decades investigating genetic causes of the conditions. He said the long-standing belief that oxygen deprivation or trauma at birth are responsible for cerebral palsy has cost specialists and their patients.

“This assumption sparked a global wave of legal claims against obstetricians in the 1990s, which had a massive impact on the mental health of clinicians,” said Emeritus Professor MacLennan, Founding Head of the Australian Collaborative Cerebral Palsy Research Group at Adelaide University’s Robinson Research Institute.

“It led to more caesarean sections being carried out amid fears of being accused of malpractice if a baby was born with cerebral palsy.

“At that time, a group of specialists met in Adelaide and found there was no current evidence to suggest that obstetric practices could reduce the risk of a diagnosis.

“That meeting was the start of a revolution in the medical world sparked here in Adelaide which made waves across the globe.”

The Adelaide conference laid the groundwork for an international consensus statement later adopted by major medical organisations, which suggested most cerebral palsy cases stemmed from factors in pregnancy or early infancy, not from injuries sustained during birth. It also clarified the criteria needed to become an expert witness in court cases relating to the condition.

Adelaide’s role in proving the science behind the cause was reinforced later by the establishment of The Australian Cerebral Palsy Biobank in 2014.

Blood samples were collected from more than 600 families of children with cerebral palsy, with parental samples and epidemiological history also analysed for genetic causes of the condition.

“We demonstrated an underlying genetic cause for at least one in four individuals with cerebral palsy, often originating from conception rather than trauma or lack of oxygen at birth,” Emeritus Professor MacLennan said.

“These findings have changed diagnostic practice for cerebral palsy, not only in Australia but across the world.”

Cerebral palsy is the most common motor disability in children, affecting around one in every 700 children born in Australia.

Adelaide University continues to play a leading role in genetic research into the condition through its Cerebral Palsy Research Group. The team is currently working on developing national pathways to make genetic testing accessible and equitable for all people diagnosed with cerebral palsy in Australia.

“During the past 20 years there have been great advances made in genetic testing and even more to come,” Emeritus Professor MacLennan said.

“Our hope is our ongoing research will lead to a clearer path to early and meaningful clinical intervention and better quality of life for patients.”

Emeritus Professor MacLennan’s article ‘How cerebral palsy litigation based on a myth and non-expert opinion adversely affected obstetric practice worldwide’ has been published in the South Australian Journal of Medicine.