Brain injury at birth

Brain injuries in babies may in some cases be linked to an infection in their mother's placenta, say researchers. They believe their research could lead to new tests that could help prevent babies being born with injuries to their brains.

These findings could eventually lead to new strategies for controlling infection and preventing brain injury

Professor Jeffrey Perlman
The crucial time is the period just before and during birth.

Children seem to be at risk if their mother develops an infection called chorioamnionitis during this period.

The infection causes fever, inflammation and abnormally high heart rates in the unborn child.

Earlier studies have pointed to lack of oxygen as the primary cause for neonatal brain injuries, including cerebral palsy.

Brain injury during the perinatal period is one of the most common causes of severe, long-term neurological problems in children.

The researchers, from the University of Texas Southwestern, studied 61 full-term infants who were admitted to a neonatal intensive care unit.

They examined the babies' umbilical cord blood for infection and also conducted extensive neurological examinations twice in the first 24 hours of life.

Inflammation

Researcher Professor Jeffrey Perlman said: "We discovered a significant correlation between the increased elevation of inflammation in the mother's placenta and a reduction in neurological function in infants.

"This is the first time such a relationship has been established.

"These findings bring us a small step closer to understanding how the brain is injured and could eventually lead to new strategies for controlling infection and, more importantly, for preventing brain injury."

By measuring specific inflammation markers in cord blood at birth and then again at 12 to 14 hours of age, researchers discovered infants with higher levels were "floppy," or had poor muscle tone.

Co-researcher Dr Octavio Ramilo said: "The five infants with the highest level of biomarkers either had a brain dysfunction known as encephalopathy or seizures."

Brain injuries in newborns usually result in weakness or paralysis, mental retardation and/or seizures.

About half of the children suffering from brain injuries must use braces, walkers, or wheelchairs as they get older.

The reason why placental infection should be linked to brain injury is unclear, but it may down to the release of immune system compounds called cytokines, or to changes to blow flow to the foetus.

Caution urged

Professor David Edwards, an expert in neonatal medicine at Imperial College, London, told BBC News Online the research was still at an early stage.

The extent of brain injury in the children who had been studied would not become apparent until they reached childhood.

Even if the initial results were subsequently confirmed, the reason why placental infection should cause brain injury would still be unknown.

The research is published in the journal Paediatrics.

Source – BBC