Protecting the brain of the micropreemie

S M Boyd; S J Tapawan; N Badawi; H Popat

doi:10.1016/j.siny.2022.101370

Protecting the brain of the micropreemie

Semin Fetal Neonatal Med. 2022 Jun;27(3):101370. doi: 10.1016/j.siny.2022.101370. Epub 2022 Jun 18.

Authors

S M Boyd¹, S J Tapawan², N Badawi³, H Popat⁴

Affiliations

¹ Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia; Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: Stephanie.boyd@health.nsw.gov.au.
² Newborn Care Centre, The Royal Hospital for Women, Sydney, Australia; School of Women's and Children's Health, University of New South Wales, NSW, Australia. Electronic address: Sarahjane.tapawan@health.nsw.gov.au.
³ Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia; Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: Nadia.badawi@health.nsw.gov.au.
⁴ Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia; Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, NSW, Australia; NHMRC Clinical Trial Centre, Medical Foundation Building, Camperdown, NSW, Australia. Electronic address: Himanshu.popat@health.nsw.gov.au.

PMID: 35752599
DOI: 10.1016/j.siny.2022.101370

Abstract

Advances in perinatal care have seen substantial improvements in survival without disability for extremely preterm infants. Protecting the developing brain and reducing neurodevelopmental sequelae of extremely preterm birth are strategic priorities for both research and clinical care. A number of evidence-based interventions exist for neuroprotection in micropreemies, inclusive of prevention of preterm birth and multiple births with implantation of only one embryo during in vitro fertilisation, as well as antenatal care to optimize fetal wellbeing, strategies for supporting neonatal transition, and neuroprotective developmental care. Avoidance of complications that trigger ischemia and inflammation is vital for minimizing brain dysmaturation and injury, particularly of the white matter. Neurodevelopmental surveillance, early diagnosis of cerebral palsy and early intervention are essential for optimizing long-term outcomes and quality of life. Research priorities include further evaluation of putative neuroprotective agents, and investigation of common neonatal interventions in trials adequately powered to assess neurodevelopmental outcome.

Publication types

Review

MeSH terms

Brain / diagnostic imaging
Cerebral Palsy* / epidemiology
Cerebral Palsy* / prevention & control
Female
Humans
Infant
Infant, Extremely Premature
Infant, Newborn
Pregnancy
Premature Birth* / prevention & control
Quality of Life