Journal
JOURNAL OF PHYSIOLOGY-LONDON
Volume 596, Issue 23, Pages 5593-5609Publisher
WILEY
DOI: 10.1113/JP275595
Keywords
perinatal brain damage; cerebral palsy; Oxidative stress; neuroprotection; prophylaxis
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Funding
- EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT [K99HD090229, R01HD069610] Funding Source: NIH RePORTER
- Department of Health, Australian Government, National Health and Medical Research Council [GNT1003517, GNT1124493] Funding Source: Medline
- NICHD NIH HHS [K99 HD090229, R01 HD069610] Funding Source: Medline
- Cerebral Palsy Alliance [PG8816] Funding Source: Medline
- Financial Markets Foundation for Children Funding Source: Medline
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This review covers our current knowledge of the causes of perinatal brain injury leading to cerebral palsy-like outcomes, and argues that much of this brain damage is preventable. We review the experimental evidence that there are treatments that can be safely administered to women in late pregnancy that decrease the likelihood and extent of perinatal brain damage that occurs because of acute and severe hypoxia that arises during some births, and the additional impact of chronic fetal hypoxia, infection, inflammation, growth restriction and preterm birth. We discuss the types of interventions required to ameliorate or even prevent apoptotic and necrotic cell death, and the vulnerability of all the major cell types in the brain (neurons, astrocytes, oligodendrocytes, microglia, cerebral vasculature) to hypoxia/ischaemia, and whether a pan-protective treatment given to the mother before birth is a realistic prospect.
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