Journal
EARLY HUMAN DEVELOPMENT
Volume 79, Issue 1, Pages 1-15Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.earlhumdev.2004.04.009
Keywords
inflammatory brain damage; preterm newborns; causal inferences
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Funding
- NINDS NIH HHS [NS040069] Funding Source: Medline
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Epidemiologic observations support the contention that infection, inflammation, and neonatal white matter damage (WMD) are associated. We also have documentation from multiple experimental models that infection/inflammation can damage developing white matter. Based on these observations in humans and animals, we offer causal inferences using widely accepted causal criteria and the multivariable model of causation. As much as we want to, however, we are reluctant to state unequivocally that inflammation causes WMD in humans born much before term. The main reason is that we lack convincing evidence that inflammation precedes WMD (temporal evidence). We also need more (and more detailed) observational studies clarifying the presumed infection --> inflammation --> WMD sequence before we can initiate intervention trials to reduce the risk of WMD. (C) 2004 Elsevier Ireland Ltd. All rights reserved.
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