Perinatal Brain Injury: Mechanisms, Prevention, and Outcomes

Christopher M Novak; Maide Ozen; Irina Burd

doi:10.1016/j.clp.2018.01.015

Perinatal Brain Injury: Mechanisms, Prevention, and Outcomes

Clin Perinatol. 2018 Jun;45(2):357-375. doi: 10.1016/j.clp.2018.01.015. Epub 2018 Mar 21.

Authors

Christopher M Novak¹, Maide Ozen², Irina Burd³

Affiliations

¹ Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 214, Baltimore, MD 21287-4922, USA.
² Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287-4922, USA; Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 228, Baltimore, MD 21287-4922, USA.
³ Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 228, Baltimore, MD 21287-4922, USA; Neuroscience Intensive Care Nursery Program, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287-4922, USA; Department of Neurology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287-4922, USA. Electronic address: iburd@jhmi.edu.

PMID: 29747893
DOI: 10.1016/j.clp.2018.01.015

Abstract

Perinatal brain injury may lead to long-term morbidity and neurodevelopmental impairment. Improvements in perinatal care have resulted in the survival of more infants with perinatal brain injury. The effects of hypoxia-ischemia, inflammation, and infection during critical periods of development can lead to a common pathway of perinatal brain injury marked by neuronal excitotoxicity, cellular apoptosis, and microglial activation. Various interventions can prevent or improve the outcomes of different types of perinatal brain injury. The objective of this article is to review the mechanisms of perinatal brain injury, approaches to prevention, and outcomes among children with perinatal brain injury.

Keywords: Cerebral palsy; Encephalopathy; Hypothermia; Intraventricular hemorrhage; Perinatal arterial ischemic stroke; Perinatal brain injury; Periventricular leukomalacia; Prevention.

Publication types

Review

MeSH terms

Adrenal Cortex Hormones / therapeutic use
Brain Injuries / congenital
Brain Injuries / mortality
Brain Injuries / prevention & control*
Brain Injuries / therapy
Combined Modality Therapy
Female
Gestational Age
Humans
Hypothermia, Induced / methods
Hypoxia-Ischemia, Brain / congenital
Hypoxia-Ischemia, Brain / diagnostic imaging*
Hypoxia-Ischemia, Brain / mortality*
Hypoxia-Ischemia, Brain / therapy
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / diagnostic imaging*
Infant, Premature, Diseases / mortality
Infant, Premature, Diseases / pathology
Infant, Premature, Diseases / therapy*
Infant, Very Low Birth Weight*
Intracranial Hemorrhages / diagnostic imaging
Intracranial Hemorrhages / prevention & control
Intracranial Hemorrhages / therapy
Leukomalacia, Periventricular / mortality
Leukomalacia, Periventricular / prevention & control
Leukomalacia, Periventricular / therapy
Magnetic Resonance Imaging / methods
Male
Neuroprotective Agents / therapeutic use
Perinatal Care / methods
Pregnancy
Prognosis
Survival Analysis
Treatment Outcome

Substances

Adrenal Cortex Hormones
Neuroprotective Agents