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Published on: November 20, 2015
Cerebral palsy and fetal inflammatory response syndrome: a review
Asher Bashiri1, Eliezer Burstein, Moshe Mazor
1Department of Obstetrics and Gynecology, Soroka University Medical Center, PO Box 151, Beer-Sheva, Israel. abashiri@bgumail.bgu.ac.il
Insights
Intrauterine infection and inflammation, leading to Fetal Inflammatory Response Syndrome (FIRS), are linked to preterm birth and cerebral palsy (CP). This inflammation can cause white matter brain damage, a key factor in CP development.
Area of Science:
- Neuroscience
- Obstetrics
- Pediatrics
Background:
- Cerebral palsy (CP) is the leading cause of severe physical disability in childhood.
- Intrauterine infection/inflammation is a primary cause of preterm delivery and neonatal complications.
- Fetal Inflammatory Response Syndrome (FIRS) is implicated in fetal injury leading to CP.
Purpose of the Study:
- To explore the link between intrauterine infection/inflammation and the development of cerebral palsy.
- To investigate the role of Fetal Inflammatory Response Syndrome (FIRS) in neonatal injury and CP.
- To examine the association between clinical chorioamnionitis and the risk of CP in preterm neonates.
Main Methods:
- Review of existing literature on intrauterine infection, FIRS, and CP.
- Analysis of studies demonstrating a relationship between intra-amniotic inflammation and CP.
- Examination of the impact of cytokine network activation on fetal brain development.
Main Results:
- Intrauterine infection/inflammation is a significant risk factor for preterm delivery.
- FIRS is associated with fetal or neonatal injury, including chronic lung disease and CP.
- Clinical chorioamnionitis increases the risk for CP, particularly in preterm infants.
- Intrauterine infection can activate cytokines, leading to white matter brain damage (periventricular leucomalacia) and CP.
Conclusions:
- Intrauterine infection/inflammation and FIRS are critical factors in the pathogenesis of cerebral palsy.
- Periventricular leucomalacia, resulting from intrauterine insults, is strongly associated with CP development.
- Understanding these mechanisms is crucial for preventing CP and improving neonatal outcomes.
Abstract:
Cerebral palsy (CP) is the most common cause of severe physical disability in childhood. The precise etiological factor for the development of the majority of cases of CP has not been identified, however, prematurity is considered to be the leading identifiable risk factor. During the last decade, intrauterine infection/inflammation has been identified as the most common cause of preterm delivery and neonatal complications. When microorganisms or their products gain access to the fetus they stimulate the production of cytokines and a systemic response termed FIRS (Fetal Inflammatory Response Syndrome). Subsequently, FIRS was implicated as a cause of fetal or neonatal injury that leads to CP and chronic lung disease. Several authors found an increase in the risk for CP in infants born to mothers with clinical chorioamnionitis, especially in preterm neonates. A relationship between CP and intra-amniotic inflammation was demonstrated, intrauterine infection may lead to activation of the cytokine network which in turn can cause white matter brain damage and preterm delivery, as well as the future development of CP. This white matter insult is identified clinically as periventricular leucomalacia (PVL) which is associated with the subsequent development of impaired neurological outcomes of variable severity including CP.
