Perinatal infections, prematurity and brain injury

Edwards, A. David; Tan, Susern

doi:10.1097/01.mop.0000193290.02270.30

Cited by 71 publications

(51 citation statements)

References 91 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Infants exposed to prenatal inflammation appear to produce more exuberant inflammatory response to postnatal stress, such as in mechanical ventilation or bacterial infection [42] . Fetal inflammatory response syndrome in combination with postnatal inflammatory stimuli increase the risk of developing BPD [13,[43][44][45][46] and adverse neurological outcomes such as cerebral white matter damage and cerebral palsy [15,47] . On the basis of epidemiologic and experimental data, T cell activation has been suggested to contribute to brain damage associated e.g.…”

Section: Adaptive Immunity Activation and Chronic Complicationsmentioning

confidence: 99%

Activation of T Cells in Preterm Infants with Respiratory Distress Syndrome

Turunen

Vaarala²,

Nupponen

et al. 2009

Neonatology

View full text Add to dashboard Cite

Background: Preterm infants with respiratory distress syndrome (RDS) present with systemic inflammation. The role of lymphocytes in RDS is less studied. Activation of lymphocytes could mediate chronic inflammation and development of bronchopulmonary dysplasia (BPD). Objective: To evaluate whether T cells are activated in preterm infants with RDS and whether T cell activation is associated with the development of BPD. Methods: Thirty-four infants with RDS [mean gestational age 27.1 (SD 2.0) weeks, birth weight 900 (216) g] were compared with 21 infants without RDS [32.6 (1.4) weeks, 1,697 (406) g]. From blood samples taken on postnatal days 1, 3, and 7, CD4 and CD8 cell counts and their expressions of co-stimulatory molecule CD54 and adhesion molecule CD62L were determined by flow cytometry. In activated cells, expression of CD54 is increased and CD62L is decreased. Results:As compared with infants without RDS, infants with RDS had less CD4 and CD8 cells on day 3 (both p = 0.02). On day 1 and day 3, RDS was associated with increased CD54 expression on CD4 cells (p = 0.001; p = 0.03) and decreased CD62L expression on CD8 cells (both p = 0.02). Infants with RDS who developed BPD (n = 18) had higher CD54 expression on CD4 cells on day 3 (p = 0.01) and on CD8 cells on day 1 and day 3 (p = 0.01; p = 0.04) as compared with infants without BPD (n = 16). Conclusions: In preterm infants, RDS is associated with a lower T cell count and a higher proportion of activated cells. Increased proportion of activated T cells predicts the development of BPD. Systemic T cell activation could mediate inflammation and development of BPD.

show abstract

Section: Adaptive Immunity Activation and Chronic Complicationsmentioning

confidence: 99%

Activation of T Cells in Preterm Infants with Respiratory Distress Syndrome

Turunen

Vaarala²,

Nupponen

et al. 2009

Neonatology

View full text Add to dashboard Cite

show abstract

“…In infants, perinatal infections have been associated with an adverse neurological outcome [3,4] . In addition, nosocomial infections have been linked with an increase in costs and prolonged hospitalization [5,6] .…”

Section: Introductionmentioning

confidence: 99%

Effect of <i>Bifidobacterium lactis</i> on the Incidence of Nosocomial Infections in Very-Low-Birth-Weight Infants: A Randomized Controlled Trial

Vossbeck²,

et al. 2010

View full text Add to dashboard Cite

Background: Nosocomial infections endanger preterm infants. Objective: The aim of the present controlled randomized trial was to investigate whether Bifidobacterium lactis reduces the incidence of nosocomial infections in infants with very low birth weight (VLBW; <1,500 g) <30 weeks of gestation. Patients and Methods: In a randomized controlled trial, 183 VLBW infants <30 weeks of gestation were stratified according to gestational age (23–26 and 27–29 weeks) and early antibiotic therapy (days 1–3, yes or no) and randomly assigned to have their milk feedings supplemented with B. lactis (6 × 2.0 × 10⁹ CFU/kg/day, 12 billion CFU/kg/day) or placebo for the first 6 weeks of life. Primary outcome was the ‘incidence density’ of nosocomial infections defined as periods of elevated C-reactive protein (>10 mg/l) from day 7 after initiation of milk feedings until the 42nd day of life (number of nosocomial infections/total number of patient days). The main secondary outcome was necrotizing enterocolitis (NEC; ≧stage 2). Results: There were 93 infants in the B. lactis group and 90 in the placebo group. There was no significant difference between the two groups with regard to the incidence density of nosocomial infections (0.021 vs. 0.016; p = 0.9, χ² test). There were 2 cases of NEC in the B. lactis group and 4 in the placebo group. None of the blood cultures grew B. lactis. Conclusion: In the present setting, B. lactis at a dosage of 6 × 2.0 × 10⁹ CFU/kg/day (12 billion CFU/kg/day) did not reduce the incidence density of nosocomial infections in VLBW infants. No adverse effect of B. lactis was observed.

show abstract

“…The causes are multiple and key factors are inflammation with excessive cytokine production, oxidative stress, and excess release of glutamate triggering the excitotoxic cascade, factors that are induced by hypoxic-ischaemic and/or infectious mechanisms, whereby a potentiation of single effects can be assumed. 15 Early in the third trimester white matter is especially affected. The major neuropathology potentially damaging the motor tracts and thus leading to CP includes periventricular leukomalacia (PVL) or complications of intraventricular haemorrhage: predominant white matter injury.…”

mentioning

confidence: 99%

MRIclassification system (MRICS) for children with cerebral palsy: development, reliability, and recommendations

Himmelmann

Horber

Cruz

et al. 2016

Develop Med Child Neuro

170

163

View full text Add to dashboard Cite

AIM To develop and evaluate a classification system for magnetic resonance imaging (MRI) findings of children with cerebral palsy (CP) that can be used in CP registers.METHOD The classification system was based on pathogenic patterns occurring in different periods of brain development. The MRI classification system (MRICS) consists of five main groups: maldevelopments, predominant white matter injury, predominant grey matter injury, miscellaneous, and normal findings. A detailed manual for the descriptions of these patterns was developed, including test cases (www.scpenetwork.eu/en/my-scpe/rtm/neuroimaging/ cp-neuroimaging/). A literature review was performed and MRICS was compared with other classification systems. An exercise was carried out to check applicability and interrater reliability. Professionals working with children with CP or in CP registers were invited to participate in the exercise and chose to classify either 18 MRIs or MRI reports of children with CP.RESULTS Classification systems in the literature were compatible with MRICS and harmonization possible. Interrater reliability was found to be good overall (k=0.69; 0.54-0.82) among the 41 participants and very good (k=0.81; 0.74-0.92) using the classification based on imaging reports.INTERPRETATION Surveillance of Cerebral Palsy in Europe (SCPE) proposes the MRICS as a reliable tool. Together with its manual it is simple to apply for CP registers.Surveillance of Cerebral Palsy in Europe (SCPE) has, through agreement in definitions and classifications of cerebral palsy (CP), developed a common language in the domain of CP.1,2 This has been a prerequisite for comparative studies, 3,4 and for studies which necessitate a large population basis. 4,5 This common language has generated a lot of interest even beyond Europe: the definitions and classifications are widely used, and SCPE papers extensively cited.CP is a clinical diagnosis, based upon neurological symptoms and a motor disorder causing an activity limitation.6 SCPE does not consider neuroimaging a prerequisite for the diagnosis of CP.2 Up to now, normal magnetic resonance imaging (MRI) does not exclude the diagnosis of CP. Moreover, neuroimaging, especially MRI, is not available nor used in all countries to the same extent. In addition, the use of MRI, as well as knowledge of its role in the understanding of CP pathogenesis, has dramatically increased during the last 15 years, which would make comparison between countries and time periods difficult. Most importantly, there is no commonly agreed neuroimaging classification for CP at this time.Although neuroimaging is not part of the CP definition, neuroimaging findings are abnormal in more than 80% of children with CP, 7-9 disclosing the pathogenic pattern responsible for the CP. Neuroimaging may also help to understand the structure-function relationship. 10,11 National guidelines recommend MRI as the first diagnostic step after history taking, neurological examination, and examination of additional impairments.12 Therefore, a need was exp...

show abstract

Perinatal infections, prematurity and brain injury

Cited by 71 publications

References 91 publications

Activation of T Cells in Preterm Infants with Respiratory Distress Syndrome

Activation of T Cells in Preterm Infants with Respiratory Distress Syndrome

Effect of <i>Bifidobacterium lactis</i> on the Incidence of Nosocomial Infections in Very-Low-Birth-Weight Infants: A Randomized Controlled Trial

MRIclassification system (MRICS) for children with cerebral palsy: development, reliability, and recommendations

Contact Info

Product

Resources

About