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What is the basis for a genetic approach in neonatal disorders?

Vineet Bhandari1, Jeffrey R Gruen2

  • 1Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT; Yale Child Health Research Center, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.

Seminars in Perinatology
|October 17, 2015
PubMed

Insights

Genetic factors influence how newborns respond to NICU treatments, impacting outcomes for conditions like bronchopulmonary dysplasia. Understanding these gene-environment interactions is key to improving neonatal care and reducing infant mortality.

Area of Science:

  • Neonatal Medicine
  • Genetics
  • Environmental Health

Background:

  • Neonatal intensive care unit (NICU) therapies have reduced mortality but not the incidence of conditions like bronchopulmonary dysplasia (BPD).
  • Observed variations in treatment response suggest underlying genetic influences.
  • Gene-environment interactions are proposed as a key factor in neonatal outcomes.

Purpose of the Study:

  • To explore the role of gene-environment interactions in neonatal outcomes.
  • To explain the persistent challenges in managing conditions like BPD despite advances in NICU care.
  • To investigate how genetic factors modulate responses to neonatal interventions.

Main Methods:

  • Review of existing literature on neonatal therapies and outcomes.
  • Analysis of twin studies indicating heritability of BPD.
  • Conceptual framework development for gene-environment interactions in neonates.

Main Results:

  • Gene-environment interactions likely explain variable responses to NICU interventions (e.g., corticosteroids, ventilation, oxygen).
  • Genetic factors may modulate the neonate's response to external agents, influencing injury and repair.
  • Heritability of BPD supports genetic involvement, but specific interactions require further differentiation.

Conclusions:

  • Gene-environment interactions are crucial for understanding and potentially improving outcomes in neonatal critical care.
  • Further research is needed to distinguish between interactions with environmental toxins/pathogens and therapeutic agents.
  • Personalized approaches considering genetic predispositions may enhance the efficacy of neonatal interventions.

Keywords:
BPDIVHNECPDARDSROPTwin studiesapnea of prematurityneonatal sepsispremature newborn

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