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Pregnancy situations have impact on brain development in pre-term infants
August 28, 2008Brain development in infants who are born very prematurely is still incomplete. Factors that cause premature birth may have an impact on the development of the premature infant's brain both during pregnancy and later on after birth. A project conducted as part of the Academy of Finland Research Programme on Neuroscience (NEURO) is concerned to study brain growth and development invery premature or low-weight infants.
The central nervous system in small premature infants is highly susceptible to damage as the immature organism tries to adapt to the intensive care environment following release from the intrauterine environment. Scientists working on the PIPARI project at Turku University Central Hospital have followed premature low-weight infants and investigated factors impacting the growth and development of their brain as well as their two-year prognosis from pregnancy onwards. A total of 232 pre-term infants have been followed and compared to 246 full-term controls. The children will be followed for a total of six years, from birth through to school age.
The results of the project indicate that the redistribution of foetal blood flow, indicative of placental insufficiency, leads to smaller brain volume in preterm infants at term equivalent age. In this situation the foetus directs a larger proportion of the blood flow to its brain.
"The mean brain volume in preterm infants with abnormal blood flow distribution was 45 millilitres smaller than in other preterm infants," says project director, Adjunct Professor Liisa Lehtonen from Turku University Central Hospital.
According to Lehtonen, the new research evidence on the impact of this volume difference on children's long-term prognosis will help to decide on the optimal timing of delivery in cases of placental insufficiency.
Degree of prematurity influences risk of brain injury
Scientists at Turku have studied the impact of placental inflammation on brain injury in preterm infants. It has been widely believed that inflammation of the placenta is responsible for many brain injuries in preterm infants. "We examined tissue samples from preterm placentas and classified them according to the amount of inflammation found in microscopic examinations. Inflammatory reactions were seen in 45 per cent of the placentas," Lehtonen says.
However, the findings suggest that placental inflammation has no independent effect on the number or severity of brain injuries or on brain growth. Inflammation of the placenta is the more common the more prematurely the infant is born, and the degree of prematurity is the single most significant risk factor for brain injury.
The project team have also investigated the impact of genetic regulation of an inflammatory transmitter (interleukin-6) on the inflammatory reaction in the placenta and on infections in the newborn infant. "A genotype causing strong inflammatory response increases the risk of placental inflammation, but on the other hand protects the child against inflammation. Our preliminary findings suggest that genetic regulation of interleukin-6 is also associated with the volume of the deep gray matter of the brain."
Lehtonen says that the follow-up results for their small preterm infants at age 2 years are better than any reported to date. Retardation in intellectual development was observed in 3.7 per cent of small preterm infants, and developmental problems, including CP injuries, in 10.8 per cent.
"In order for us to create treatments that can help protect the development of the brain, it's essential that we systematically follow up the development of preterm infants: this should always be an integral part of the care of preterm infants," Lehtonen emphasises.
Academy of Finland
"The mean brain volume in preterm infants with abnormal blood flow distribution was 45 millilitres smaller than in other preterm infants," says project director, Adjunct Professor Liisa Lehtonen from Turku University Central Hospital.
According to Lehtonen, the new research evidence on the impact of this volume difference on children's long-term prognosis will help to decide on the optimal timing of delivery in cases of placental insufficiency.
Degree of prematurity influences risk of brain injury
Scientists at Turku have studied the impact of placental inflammation on brain injury in preterm infants. It has been widely believed that inflammation of the placenta is responsible for many brain injuries in preterm infants. "We examined tissue samples from preterm placentas and classified them according to the amount of inflammation found in microscopic examinations. Inflammatory reactions were seen in 45 per cent of the placentas," Lehtonen says.
However, the findings suggest that placental inflammation has no independent effect on the number or severity of brain injuries or on brain growth. Inflammation of the placenta is the more common the more prematurely the infant is born, and the degree of prematurity is the single most significant risk factor for brain injury.
The project team have also investigated the impact of genetic regulation of an inflammatory transmitter (interleukin-6) on the inflammatory reaction in the placenta and on infections in the newborn infant. "A genotype causing strong inflammatory response increases the risk of placental inflammation, but on the other hand protects the child against inflammation. Our preliminary findings suggest that genetic regulation of interleukin-6 is also associated with the volume of the deep gray matter of the brain."
Lehtonen says that the follow-up results for their small preterm infants at age 2 years are better than any reported to date. Retardation in intellectual development was observed in 3.7 per cent of small preterm infants, and developmental problems, including CP injuries, in 10.8 per cent.
"In order for us to create treatments that can help protect the development of the brain, it's essential that we systematically follow up the development of preterm infants: this should always be an integral part of the care of preterm infants," Lehtonen emphasises.
Academy of Finland
Preterm Infants Current Events and Preterm Infants News RSSMedImmune to present data on RSV and influenza at 2009 AAP National Conference and Exhibition
MedImmune announced today it will present four abstracts at the American Academy of Pediatrics (AAP) 2009 National Conference & Exhibition that add to the company's growing body of research on the burden of respiratory syncytial virus (RSV) on children, as well as pediatric infectious disease prevention.
More infants surviving pre-term births results in higher rates of eye problems
As more extremely pre-term infants survive in Sweden, an increasing number of babies are experiencing vision problems caused by abnormalities involving the retina.
Debate on administration of magnesium sulfate to pregnant women to prevent cerebral palsy in preterm infants
Cerebral palsy (CP) is the most prevalent chronic childhood motor disability with an estimated lifetime cost of nearly $1 million per individual.
Even mildly premature infants have increased risk of a common respiratory tract infection
Even mildly premature infants (gestational ages of 33 weeks through 36 weeks) have an increased risk of medically attended respiratory syncytial virus infection, which is the leading cause of lower respiratory tract infection in infants and young children and can lead to pneumonia in babies.
MedImmune presents new data showing burden of RSV disease
MedImmune today announced results from a recent study it sponsored, performed by the Kaiser Permanente Division of Research in Oakland, CA, assessing risk factors for respiratory syncytial virus (RSV) infection requiring medical treatment in infants born at 33 weeks gestational age [GA] or later.
New, simple method identifies preterm infants at risk of eye disease
A simple way of establishing which preterm infants are at risk of developing the eye disease ROP is to follow their weight gain.
Estrogen activates critical lung genes to improve lung function following preterm birth
Estrogen may be a new postnatal therapy to improve lung function and other outcomes in preterm infants, researchers at UT Southwestern Medical Center have found in an animal study.
Preterm births rise 36 percent since early 1980s
New government statistics confirm that the decades-long rise in the United States preterm birth rate continues, putting more infants than ever at increased risk of death and disability.
SIDS link: Low blood pressure in preterm infants
Scientists from Monash University, Melbourne have shown that infants born prematurely have lower blood pressure during sleep in the first six months of life, compared to healthy, full-term infants.
Scientists show gene mutation may cause immature lungs in newborns
Scientists have identified a gene critical to lung maturation in newborns and the production of surfactant, which lines lung tissues and prevents the lungs from collapsing.
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