The Japan Council for Quality Health Care (JCQHC), a juridical person mentioned in this blog in the past, has issued a report on the relationship between cerebral palsy (CP) and labor inducing drug (LID) use. It says 30% of CP cases were given LID during delivery and, in almost 80% of those cases, the obstetricians were not compliant to the guide line of LID use issued by an academic society of obstetrics. The report carefully evades expressing cause and result relationship between CP and LID use.
The mass media has taken this news as a big topic. In the news, the expression is so stereotypic that the readers or listeners are lead to believe LID use or "abuse" resulted in asphyxia of the neonates, which eventually caused CP later. What the mass media says in this way is not right.
The real causes of CP have not been elucidated yet. Not the neonatal asphyxia but intrauterine issues have been known to be the main cause of CP. Recent progress in genetic analysis for CP cases and CP related cases has revealed a number of them are due to genetic disorders like the other genetic neuromuscular disorders. A recent review of this subject has stressed that a growing amount of evidence suggests multiple genetic factors responsible for the etiologies of CP.
It says, despite of the drastic improvement in medical science for the past 4 decades, the prevalence of CP remains the same level as 2 or 3 per 1000 live birth. Though electronic fetal monitoring, now widely used to detect fetal distress from fetal distress, has not decreased this prevalence rate. A number of large scaled controlled studies have shown, as this review says, birth asphyxia accounts for only less than 10% of CP cases. These findings strongly argue against that LID use or abuse has caused CP as JCQHC report or the mass media says.
Why does JCQHC or the mass media try to mislead the people as for this medical issue? This juridical person has got a big amount of reserve from the compensation system for CP cases, as I have told in the previous post. They confront to severe criticism against such a scheme and against their unwillingness to reform the system. Insisting of this "malpractise" causing CP cases in obstetrics, they seem to try to make our eyes turned away from such a problem. The mass media, being ignorant of the facts known in medical science, only need any news sensationally attracting the people's eyes. Both of them are not concerned if such a campaign would destroy clinical services in obstetrics, which have already been exposed to groundless lawsuit.