One of the first and most painful questions parents ask is, "Did I cause this?" The honest, reassuring answer is that encephalocele is almost never the result of anything a parent did.
The short answer
Encephalocele is caused by the neural tube failing to close completely in early pregnancy. Why that happens in a given baby is usually not fully known. Most cases appear to result from a combination of genetic and environmental factors rather than a single cause, and most occur sporadically — out of the blue, in families with no history.
Genetic factors
There is a genetic component for some families. Encephalocele is more common in families with a history of neural tube defects such as spina bifida or anencephaly. Certain genes have been linked to specific types — for example, changes in the CEP290 gene have been associated with some occipital (back-of-head) encephaloceles. And more than 30 genetic syndromes can include encephalocele as a feature (covered in a later article).
Environmental and maternal factors
Researchers have studied several factors that may raise the risk of neural tube defects in general, including:
- Folate (folic acid) deficiency before and during early pregnancy
- High body temperature in early pregnancy (high fever, possibly hot tubs/saunas)
- Maternal diabetes that isn't well controlled
- Obesity
- Certain medications, such as some anti-seizure drugs
- Possible exposure to certain toxins or infections
Important nuance: while folic acid clearly lowers the risk of anencephaly and spina bifida, the protective effect specifically for encephalocele is less firmly established. Even so, adequate folic acid is recommended for all women who could become pregnant, because it prevents other serious neural tube defects.
Why "you didn't cause this" is the truth
The closure step happens in the first month, frequently before a pregnancy is known. Encephalocele is not caused by a fall, by stress, by lifting, or by ordinary daily life. Carrying guilt is understandable, but it isn't supported by the science.
Sources
- CDC — Encephalocele (Birth Defects)
- NORD — Encephalocele
- StatPearls (NCBI Bookshelf) — Encephalocele
- Nationwide Children's Hospital — Encephalocele
- Cleveland Clinic — Encephalocele