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Perinatal Neuroprotection in Preterm Birth
Richard Berger1, Patrick Stelzl2, Johannes Stubert3
1Klinik für Gynäkologie und Geburtshilfe, Marienhaus Klinikum St. Elisabeth, Akademisches Lehrkrankenhaus der Universitäten Mainz und Maastricht, Neuwied, Germany.
Geburtshilfe Und Frauenheilkunde
|October 15, 2025
Summary
Preterm birth can cause infant brain damage. Optimal care in a level I perinatal center, including antenatal corticosteroids and magnesium, improves neurodevelopment. Breast milk is vital for long-term brain health.
Area of Science:
- Neonatal care
- Neuroscience
- Perinatal medicine
Background:
- Preterm birth is a leading cause of infant morbidity and mortality.
- Significant rates of severe brain injury (grade III/IV cerebral hemorrhage, periventricular leukomalacia) occur in very low birth weight infants.
- MRI studies reveal diffuse white and grey matter injuries in preterm infants, impacting brain development.
Purpose of the Study:
- To highlight the critical need for specialized perinatal care for preterm infants.
- To identify key perinatal measures that promote optimal neuronal development.
- To emphasize the importance of a neuroprotective environment beyond initial intensive care.
Main Methods:
- Review of current literature on preterm infant brain injury and neuroprotection.
- Analysis of outcomes associated with level I perinatal center care.
- Evaluation of specific perinatal interventions (antenatal corticosteroids, magnesium, delayed cord clamping).
Main Results:
- Level I perinatal center care is essential for infants <1500g birth weight.
- Antenatal corticosteroids, magnesium, and delayed cord clamping improve neuronal development.
- Hypothermia treatment is not suitable for neuroprotection in preterm infants.
Conclusions:
- Optimal neurodevelopment in preterm infants requires immediate specialized care in a Level I perinatal center.
- A combination of antenatal interventions and a supportive postnatal environment, including breast milk, is crucial.
- Long-term neuroprotection involves managing inflammation and providing trophic stimulation in the NICU.
