Publications by authors named "C Lear"
Article Synopsis
- Perinatal hypoxia-ischaemia in extremely preterm infants leads to long-term neurodevelopmental issues, and while insulin-like growth factor-1 (IGF-1) can help with acute brain injuries, its effects on chronic brain damage are not well understood.
- In a study with preterm-equivalent fetal sheep, subjects that underwent asphyxia demonstrated significant brain damage, including loss of white matter and inflammation.
- However, prolonged treatment with IGF-1 after asphyxia improved white matter recovery and reduced inflammation, suggesting it may enhance brain maturation in preterm infants affected by severe asphyxia.
Preventive, rescue and reparative neuroprotective strategies for the fetus and neonate.
Semin Fetal Neonatal Med
November 2024
Article Synopsis
- * Factors influencing the severity of injury include the maturity of the infant, the nature of the hypoxia-ischaemia exposure, and complications like impaired placental function and fetal growth restriction, along with socio-economic factors.
- * The review highlights the complex role of chorioamnionitis in neonatal injury and suggests that advancements in fetal monitoring could lead to better identification of injury risks and opportunities for preventive treatments before and after birth.
Fetal hypoxemia is ubiquitous during labor and, when severe, is associated with perinatal death and long-term neurodevelopmental disability. Adverse outcomes are highly associated with barriers to care, such that developing countries have a disproportionate burden of perinatal injury. The prevalence of hypoxemia and its link to injury can be obscure, simply because the healthy fetus has robust coordinated defense mechanisms, spearheaded by the peripheral chemoreflex, such that hypoxemia only becomes apparent in the minority of cases associated with stillbirth, severe metabolic acidemia or adverse neurodevelopmental outcomes.
View Article and Find Full Text PDFArticle Synopsis
- Antenatal hypoxia-ischaemia (HI) in preterm fetal sheep can lead to severe white matter injury (WMI), paralleling conditions observed in preterm infants.
- The study involved preterm fetal sheep, which experienced a 25-minute umbilical cord occlusion or a sham procedure, followed by a 21-day recovery period to assess changes in electroencephalographic (EEG) activity.
- Results indicated that following HI, there was a significant shift to lower frequency EEG activity, a decrease in sleep state cycling, and an abnormal transition to a high-frequency state, which may signal evolving WMI.