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Published on: November 20, 2015
Recent advances in perinatal neuroprotection
Samata Singhi1,2, Michael Johnston1
1Department of Neurology, Kennedy Krieger Institute, Baltimore, Maryland, 21205, USA.
Insights
This review covers neuroprotective strategies for infants to prevent perinatal brain injury. It examines established, emerging, and novel therapies to reduce neurological disability in newborns.
Area of Science:
- Neonatal neurology
- Perinatal medicine
- Neuroprotection
Background:
- Perinatal brain injury is a significant cause of neurological disability in premature and term infants.
- Effective neuroprotective strategies are crucial for improving infant outcomes.
Purpose of the Study:
- To review established, emerging, and novel neuroprotective practices for perinatal brain injury.
- To summarize current evidence and ongoing research in the field.
Main Methods:
- Review of established neuroprotective practices: antenatal steroids, intrapartum magnesium, therapeutic hypothermia.
- Examination of emerging practices: delayed cord clamping, postnatal magnesium, recombinant erythropoietin, NSAIDs.
- Exploration of novel interventions in trials: xenon, melatonin, topiramate, allopurinol, creatine, autologous cord cell therapy.
Main Results:
- Established therapies demonstrate efficacy in preventing neurological damage.
- Emerging practices show promise and are under further investigation.
- Novel interventions are in clinical trials, offering potential future therapeutic options.
Conclusions:
- A range of neuroprotective strategies exist, from established to experimental.
- Continued research and clinical trials are vital for advancing infant brain injury prevention.
- Multifaceted approaches may be necessary to optimize neuroprotection in perinatal settings.
Abstract:
Perinatal brain injury is a major cause of neurological disability in both premature and term infants. In this review, we summarize the evidence behind some established neuroprotective practices such as administration of antenatal steroids, intrapartum magnesium for preterm delivery, and therapeutic hypothermia. In addition, we examine emerging practices such as delayed cord clamping, postnatal magnesium administration, recombinant erythropoietin, and non-steroidal anti-inflammatory agents and finally inform the reader about novel interventions, some of which are currently in trials, such as xenon, melatonin, topiramate, allopurinol, creatine, and autologous cord cell therapy.
