Oxygen deprivation at birth - and behavioural problems later??? any thoughts

[SunisShinin]

I may live to regret asking the question but does anyone have any knowledge or experience of behavioural problems in a children being linked to difficult births or lack of oxygen during delivery?

I've posted a few times about ds1(4) being referred for ASD assesment. Special needs lady came to house Monday and said she def agreed there was something but it didn't look like ASD. She's asked Ed Psych to visit at home and pre-school - this is addition for Paeds referal made by HV.

The things is ds1 had a pretty terribe birth. After 20+ hour labour during which his heartrate had been dipping and recovering it dipped to just 80bpm and did not recover. I had to be transferred so it was 90mins between drop inb heart rate and birth by C section under GA. I'm pretty sure that shortly before they knocked me out the heart rate was approx 60bpm.

Next day obs dr visited and apologised for GA but said it had been necessary to deliver asap as 'i thought your baby would be brain damaged' - words a new mum always wants to hear. I remember that pre-op I saw there was a paeds team ready to take him to SCUBU but miraculously he was deivered with APGAR of 9 and needed no additional support.

To date he has hit all of his milestones but for last 12 months has started to lag in language development, and has real problems concetrating.

Sorry for long posts but thought background might help.

[amberflower]

Hello, this is a really interesting post as it has made me think about my DS. His birth was very nearly a crash section (they managed to get a spinal block in as DS's heartrate did stabilise once in theatre) but at the point of the midwife pressing the emergency call button his heartrate had dipped to 54bpm, and it had been up and down like a yoyo all night before they made the decision to deliver by C section. I'd been induced at term for mild pre-eclampsia, and the general consensus was that DS wasn't coping with the very strong contractions triggered by induction.

Now, like your DS mine has hit every single developmental milestone with no problems at all, but concerns have been raised by his teachers since starting school and he is lagging behind peers in certain areas. He'll be 5 in July, so some of this could be due to the fact he's one of the youngest in the year, and has only been full time since April. But he too has problems with concentration (tends to 'tune out' a lot, particularly when instructions given to whole class) and also problems with fine motorskills (very poor pencil control, immature writing/drawing skills given that he's been in reception nearly a year). No concerns about expressive language although slight question mark over receptive (this ties in with not always concentrating, I think) and he can be quite withdrawn in a large group environment.

At school's instigation he was assessed by OT, SALT and paed and now receives OT for the fine motor stuff, the paed also verbally diagnosed mild ASD though we plan to ask for a second opinion on this including home and school ed psych assessment as we are not convinced. We're still waiting for the formal written report though so can't do much till that comes through.

But I hadn't really made any connection between his birth and the issues he is now having, until reading your post. You've got me thinking now. We certainly weren't told anything worrying at birth, just that all was fine (DS too scored the maximum APGAR, came out healthy and was a fabulously easy baby) but they had wanted to deliver due to his erratic heartbeat. Maybe there is a connection. It's certainly a plausible explanation, at least to my non-medical brain...

[SunisShinin]

I only thought aboout it as someone sugessted ADD / ADHD as many of the symptoms are like ASD. A quick google showed proven connection between birth hypoxia and ADD so wondered if there were any other conditions that could be linked. My ds sounds just like yours - poor concentration, can't / won't use pencil for long, very poor listening skills, erractic and impulsive behaviour - but also has multitude of sensory issues hence query ASD. Starting school in sept - needless to say I am terrified.

[BriocheDoree]

I'm not sure if this is one of those things you'll ever know.
I have DD, 5, with speech / language disorder, autistic traits, slightly behind on motor skills, problems with attention. Was an emergency section for foetal distress after prolonged labour.
Do I wonder if her birth caused her problems? Well, yes, particularly as I now have DS, 2, VBAC, slightly slow on motor skills (only walked at 22 mos) but talking lots, communicating more than DD does, good attention, most likely NT...
However, I don't think I'm ever going to know, and I'm not sure if someone could tell you, either.
DD started school at 3 (we're in France) and it was brilliant for her. Attention has improved, behaviour improved, social skills way behind her peers but loads better than they were. Sometimes school is a good thing, too! (Trying to be reassuring!)

[fatzak]

Mmm - DS1 despite being a very quick birth had a dipping heart rate and ended up being a ventouse delivery. He has epilepsy, awful concentration, slightly odd language skills etc. An MRI showed a small patch of the brain with possibly signs of oxygen deprivation but they have ruled out it being linked to his seizures

[glitteryb6]

a woman i know of who was due at the same time as me had her wee boy 2 weeks before ds at 24 weeks, ds was born at 26 weeks, i always wondered why ds was so physically disabled and her ds had no physical problems, he can walk, talk, run, you name it.
i found out a few months ago he has been diagnosed as Autistic so maybe you never really get away scot free from a premature/problematic birth?

[Greensleeves]

my ds1 didn't breathe for 7 minutes and had apgar score of 1 and 1 minute and 2 at 5

he has AS

I sometimes wonder whether the two are related - but then I wonder about lots of other possible factors too, such as not being held or talked to by his mother until he was more than a day old

I would go mad if I allowed myself to explore all these avenues as far as I am tempted to

[amberflower]

Sunisshinin - I would agree with BriocheDoree - school can be a good thing! When is your DS five, and what have his preschool said? Do they share your concerns? Sometimes children are fine at school and save all their 'traits' for home. Our DS is the other way around, we never had any real concerns until teachers identified them.

I won't lie to you, I've found DS's first year at school pretty stressful, mainly because the discovery of his need for additional help came as a bit of a shock. But school have also been very good in identifying concerns and acting on them, and he has settled well and made a lot of progress. For example this time last year he could barely copy a circle or cross, knew his basic alphabet and numbers but no more. He is now reading full sentences in his reading books, knows most of the reception-stage words, can confidently write his name and copy the majority of the rest of the alphabet letters, and can draw rudimentary pictures (stick people etc). Okay, his handwriting's a bit pants, and his pencil grip's clumsy - but you know what, one step at a time

What I would also say is that DS has learned to adapt to certain aspects of school he initially found very daunting. For example, the only real sensory issue we have is loud noises - he can get very scared - and he definitely found things like whole-school assembly very overwhelming at first. Soon enough, however, he was fine. You may well find that your DS develops similar coping strategies. Often it's about them learning what the routines are and being confident with them.

I do think that as people have said, we will probably never know re link between birth and possible ADD/ASD etc. Though I have to say that just thinking about it as a possibility has helped me accept that this could be a 'reason' for DS's issues, and that in itself has been helpful. I have been torturing myself with 'whys' since his assessment. So thank you for starting the thread!

[juliaw]

You can ask for your notes and to talk them through with the paed. Brain damage eg CP would show up on an MRI scan. You could ask paed to discuss whether scanning your child would give you any answers.

[wigglybeezer]

I had a crash section under GA due to foetal distress (for DS1, he was tangled up in the cord), I have often wondered if oxygen deprivaton has contributed to him finding so many things difficult BUT his apgar score was 9 and he hit all his milestones bang on average eg. walked at 12 months etc. so I tend to talk myself out of it, it is probably genetic in our case. Saying that, DS2 has a tough forceps birth and he has problems too and DS3 is NT and he had a relaxed, non urgent section delivery...hmmm jury still out but definitely interesting.
I also used to worry about my bond with DS1 not being good enough because of the effects of the GA (missing his first hour and first feed etc.).

[mysonben]

I had a prolonged labour after an induction ds was 11 days late, and there was concerns with ds'heartbeat dipping at times and the docs took twice some blood from ds'haed during labour to check on his oxygen levels. I had an c/section in the end and ds had 7 agpar score then 9 ten mins later.

DS has mild asd , and a huge speechh delay. I 'm not sure if there is a connection???
I hope not because i tried a vbac for dd and it went really wrong ddd 'heartbeat went very low i was told so it was a rush to theatre to have an emergency c/section under GA.

[amberflower]

You know, the more I think about it, the more I think it is probably a combination of factors. In our case, it could be that DS's issues with fine motor skills may be, possibly, might be linked to his delivery...then again maybe not...his concentration issues and lack of social confidence could just as easily be genetic. Or just 'one of those things'.

Let's face it there will be thousands of children out there who had dodgy heartrate during labour, traumatic births, low APGAR, poorly mothers who weren't able to bond straight away after birth and so on and so on....and I bet the vast majority of them have no issues at all.

So I guess the key thing is it's an interesting discussion point but we shouldn't torture ourselves.

[Greensleeves]

ds1 had very low apgar and was rescuscitated etc, but he walked at 9mo. And has AS. Is it really possible that there's a link? I don't know.

[SunisShinin]

I didn't mean to start you all mentally torturing yourselves- although I guess that seems to be the norm for all mothers. More wondered if there were any conditions where the link was proven.

Unfortunately a large part of my birth notes are missing. Obs requested them when I was pregnant with ds2 to help delivery decision but chunk relating to late labour and delivery was missing - and to date I haven't been strong enough in myself to persue it.

Will stop torturing myself and wait to see what ed psych says.

Good to hear others say their dc exhbits in some places not others. Pre-school have no problems at all. Some of my close family have seen him in action so I do have some support for my concerns.

[StillUnderThirthy]

In a nutshell:

DD brain bleed and lack of oxygen, emergency C-Section, AGPAR 0.

at 24m, dev delays, walked at 18, no words.

I just wanted to add that people who dealt with same as us at birth but whose dc are NT, will not be on this board...

Good luck with school

[daisysue2]

My daughter is adopted and we were told that her birth mother was a bit slow because she was starved of oxygen at birth. But my daughter has exactly the same problems as she has.

[whateverittakes]

Oxygen starvation at birth is linked to all sorts of learning difficulties. The first part of the brain to be affected is the hippocampus, the centre of memories. Difficulty with short term and working memory is affected. This makes learning, especially in school, particularly difficult.

My son, 15, was oxygen starved at birth, spent 5 days in special care. He has ADHD, predominantly inattentive type - ie he tunes out and cannot focus unless he is really motivated. It takes a lot of hard work to get information into his long term memory. School and life in general is a challenge. Puberty adds a layer and causes additional stress due to self-esteem issues from an inability to deliver according to his intelligence, meet adult expectations etc.

I was unaware at first of the long term damage, however subtle, that oxygen deprivation at birth causes. Do not blame your child for being lazy, tantrumming, not fitting in with teacher expectations etc. Do not blame yourself. Just trust your instincts and do whatever it takes to support your child.

[coff33pot]

My DS was nearly miscarried at 4 months, delivered 6 weeks early by emergency C section was under distress but apgar was fine. He was born with two true knots in his cord. He talked at 9 months, walked before 12months and got along fine but has learning, emotional, communication and sensory difficulties and is being assessed for AS/ASD. I have always thought it was his birth that has played a part in his issues. But in a way it helps me to stop the odd niggling doubt that it was something that I had done that has caused his problems in the first place.

[WasUnderThirthy]

Funny to run in an old thread, as the OP's question is still so relevant for us.

My dd, now 4, has just been dx with ASD and ADHD, and yes she has a looot of behaviour issues. Her brain was affected in the frontal lobe area, which controls emotions, so we will never know if it is all related, but probably.

[lisapalli]

hi ive been thinking for a few yrs now that my daughters special needa is down to the traumatic birth i had,,,I was induced and was in labour i was asked if i wanted an epidural and i said yes the lady came to give me the epidural and i couldnt sit still as i told them i was ready to push only to b told i wasnt dilated enough anyway they couldnt do the epidural so they said and i turned onto my back only to b told i was fully dilated and i could push and i said that was what i said and during pushing i was in complete agony in my back and discovered my epidural went wrong and i was pusing for ages and in complete agony in my back eventually i was told they were gonna take me to theatre and try to give me a spinal i was sat ready and started gettin extreme pain going down my spine,they told me off and said they hadnt even touched me yet and then they said they couldnt do it so i was told i would b having a general but it took so long i was so scared and even told the doc to get her out and give her to my husband obviously i was put under at that stage but it was a long time for them to get her out ,,i was told a few days later after being in agony in my back after the drugs wore off they had burst the fluid back in my side and had to have a blood pack put into my spine so iwas in there for 9days anyway my daughter has had and is still having speech problems,behaviour problems,learning problems,language problems,memory problems etc and weve had a psycilogical report done but we are trying to get other tests done too

[auntevil]

DS1 was a long labour - established 71 hours - but didn't show signs of distress - and there was always someone more important to deal with. In all, it took nearly a week to meet him face top face . DS was an 'emergency' C S - approx 10 hours after being told I needed one.
It turns out that he had got his head stuck - so pressure on his soft skull for up to week. Dx is dyspraxia, but also SPD and hypermobility. His short term /working memory is atrocious

[blueShark]

Although I'm a firm believer most issues are genetical I also think that a traumatic birth can make those things worse. Ds1 was longest labour and nit as pink as the others 2 that are nt. Ds1 didn't show any sign of distress, apgar 9 bt failed to latch and breastfeed, cried for no reason in early days and never slept well as my other two either.

[Gottalovecosta]

DS was born at 35 weeks, cord round his neck three times. He had an APGAR of 9 but was floppy and slow to meet milestones, and is being assessed for ASD/ADHD and has complex behavioural problems.
I do often wonder about his birth, and wonder if its genetics/his birth.

[Chundle]

My dd2 was born at 32 wks by emer c section. Was taken in with contractions over a period of 12 hrs from 10pm to 10am in hosp her heartrate dropped constantly lowest was 30bpm but kept recovering. Then they lost it altogether. Midwife was very concerned but consultant said to wait til morn as kept recovering!!! I do wonder what impact this 12 hr wait has had on her. She was slow to roll over slow to talk and is now anxious, shy , bad sleeper, behaviour issues and awaiting ados. She's 2.5. I wrote to hosp and got fobbed off