Pathophysiology of perinatal asphyxia: can we predict and improve individual outcomes?
Paola Morales1, Diego Bustamante, Pablo Espina-Marchant
1Programme of Molecular & Clinical Pharmacology, ICBM, Medical Faculty, University of Chile, PO Box 70.000, Santiago 7, Chile.
Insights
Perinatal asphyxia, a condition from prolonged delivery, can cause neurological issues in infants. This review explores biomarkers, sequelae, and therapeutic targets for better prediction and treatment of birth asphyxia outcomes.
Area of Science:
- Neuroscience
- Neonatology
- Biochemistry
Background:
- Perinatal asphyxia remains a significant cause of infant neurological sequelae despite advances in perinatal care.
- The severity of neurological damage is influenced by insult extent, re-oxygenation, and brain region development.
Purpose of the Study:
- To review current understanding of perinatal asphyxia pathophysiology.
- To identify early diagnostic biomarkers and novel therapeutic targets for improved infant outcomes.
Main Methods:
- Literature review of perinatal asphyxia research.
- Analysis of biomarkers, neurological sequelae, neurocircuitry, molecular pathways, and neuroinflammation.
- Discussion of endogenous brain rescue mechanisms and therapeutic strategies.
Main Results:
- Progress has been made in understanding asphyxia, but predictive diagnostics and personalized therapies are nascent.
- Emphasis is shifting towards early, non-invasive diagnosis and identifying new therapeutic targets.
Conclusions:
- Early non-invasive diagnosis and targeted therapies are crucial for mitigating perinatal asphyxia effects.
- Further research into biomarkers and therapeutic targets can improve individual outcomes for affected infants.
Abstract:
Perinatal asphyxia occurs still with great incidence whenever delivery is prolonged, despite improvements in perinatal care. After asphyxia, infants can suffer from short- to long-term neurological sequelae, their severity depend upon the extent of the insult, the metabolic imbalance during the re-oxygenation period and the developmental state of the affected regions. Significant progresses in understanding of perinatal asphyxia pathophysiology have achieved. However, predictive diagnostics and personalised therapeutic interventions are still under initial development. Now the emphasis is on early non-invasive diagnosis approach, as well as, in identifying new therapeutic targets to improve individual outcomes. In this review we discuss (i) specific biomarkers for early prediction of perinatal asphyxia outcome; (ii) short and long term sequelae; (iii) neurocircuitries involved; (iv) molecular pathways; (v) neuroinflammation systems; (vi) endogenous brain rescue systems, including activation of sentinel proteins and neurogenesis; and (vii) therapeutic targets for preventing or mitigating the effects produced by asphyxia.
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