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Reducing Brain Injury of Preterm Infants in the Delivery Room

Francesca Viaroli1,2, Po-Yin Cheung1,2, Megan O'Reilly1,2

  • 1Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, AB, Canada.

Frontiers in Pediatrics
|November 3, 2018
PubMed

Insights

Preterm birth can cause cerebrovascular injury. Strategies like controlled resuscitation and monitoring can minimize brain damage, while postnatal treatments may improve neurodevelopmental outcomes.

Area of Science:

  • Neonatal neurology
  • Perinatal medicine
  • Neuroprotection

Background:

  • Cerebrovascular injury is a significant complication of preterm birth.
  • Factors like hypothermia, low cerebral oxygen saturation during resuscitation, and high tidal volumes increase the risk of neonatal brain lesions.

Purpose of the Study:

  • To identify key factors contributing to brain injury in preterm infants immediately after birth.
  • To explore preventive and therapeutic strategies to minimize neurological damage and improve long-term outcomes.

Main Methods:

  • Review of recent studies on factors influencing neonatal brain injury.
  • Discussion of monitoring techniques during delivery room resuscitation (pulse oximetry, near-infrared spectroscopy, alpha EEG).
  • Consideration of timing of cord clamping and respiratory support parameters.

Main Results:

  • Hypothermia, reduced cerebral oxygen saturation, and high tidal volumes are linked to severe neurologic injury.
  • Monitoring physiological changes and optimizing respiratory support are crucial for prevention.
  • Postnatal treatments like caffeine show potential for improved neurodevelopment.

Conclusions:

  • Applying knowledge about causes and prevention of brain injury before and at birth is essential for preterm infants.
  • Implementing preventive measures during resuscitation and considering novel postnatal therapies can mitigate brain injury and enhance neurodevelopmental outcomes.

Keywords:
brain injuryinfantsintraventricular hemorrhageneonatal resuscitationnewbornvery low birth weight infants

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