Why Does Perinatal Morbidity Increase

Visser, Gha

doi:10.1515/jpme.1994.22.s1.28

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Epidemiological studies conducted in the last decades have shown that, despite technological improvement in high-risk newborns and children management, the pattern of neurological handicap incidence in developed countries has a flat trend (4).…”

Section: Epidemiology Of Perinatal Asphyxiamentioning

confidence: 99%

Biochemical markers of perinatal brain damage

et al. 2010

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Hypoxia-ischemia constitutes a risk in infants by altering cerebral blood flow regulatory mechanisms and causing loss of cerebral vascular auto-regulation. Hypotension, cerebral ischemia, and reperfusion are the main events involved in vascular auto-regulation leading to cell death and tissue damage. These dramatic phenomena represent a common repertoire in infants complicated by perinatal acute or chronic hypoxia. To date, despite accurate perinatal and intra-operative monitoring, the post-insult period is crucial, since clinical symptoms and monitoring parameters may be of no avail and therapeutic window for pharmacological intervention (6-12 hours) may be limited, at a time when brain damage is already occurring. Therefore, the measurement of circulating biochemical markers of brain damage, such as vasoactive agents and nervous tissue peptides is eagerly awaited in clinical practice to detect high risk infants. The present review is aimed at investigating the role as circulating biochemical markers such as adrenomedullin, S100B, activin A, neuronal specific enolase (NSE), glial fibrillary acid protein (GFAP), in the cascade of events leading to ischemia reperfusion injury in infants complicated by perinatal asphyxia.

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Section: Epidemiology Of Perinatal Asphyxiamentioning

confidence: 99%

Biochemical markers of perinatal brain damage

et al. 2010

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“…Epidemiological studies have shown that in high-risk newborns the pattern of neurological handicap incidence in developed countries has a flat trend [1]. Perinatal asphyxia (PA) occurs in 0.2-0.4% of fullterm births, of these 20% suffer from mortal hypoxicischemic encephalopathy (HIE); of the survivors, 25% exhibit permanent neuropsychological deficits [2].…”

Section: Perinatal Asphyxiamentioning

confidence: 99%

New markers of neonatal neurology

Gazzolo

Abella

Marinoni

et al. 2009

The Journal of Maternal-Fetal & Neonatal Medicine

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Hypoxia-ischemia (H-I) constitutes the main phenomenon responsible for brain-blood barrier permeability modifications leading to cerebral vascular auto-regulation loss in newborns. Hypotension, cerebral ischemia, and reperfusion are the main events involved in vascular auto-regulation loss leading to cell death and tissue damage. Reperfusion could be critical since organ damage, particularly of the brain, may be amplified during this period. An exaggerated activation of vasoactive agents, of calcium mediated effects could be responsible for reperfusion injury (R-I), which, in turns, leads to cerebral hemorrhage and damage. These phenomena represent a common repertoire in newborns complicated by perinatal acute or chronic hypoxia treated by risky procedures such as mechanical ventilation, nitric oxide supplementation, brain cooling, and extracorporeal membrane oxygenation (ECMO). Despite accurate monitoring, the post-insult period is crucial, as clinical symptoms and standard monitoring parameters may be silent at a time when brain damage is already occurring and the therapeutic window for pharmacological intervention is limited. Therefore, the measurement of circulating biochemical markers of brain damage, such as vasoactive agents and nervous tissue peptides is eagerly awaited in clinical practice to detect high risk newborns. The present review is aimed at investigating the role of biochemical markers such as adrenomedullin, a vasoactive peptide; S100B, a calcium binding protein, activin A, a glycoprotein, in the cascade of events leading to I-R injury in newborns complicated by perinatal asphyxia.

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“…Despite the continuous improvements in perinatal care, perinatal brain injury (PA), due to hypoxic-ischemic (H-I) insult, still remains the main cause of developmental disability in children [1][2][3][4]. PA incidence is around 0.2%-0.6% in term births [5], and neurological handicap affects about 50%-75% of this population of children [6].…”

Section: Introductionmentioning

confidence: 99%

Biochemical Markers for Brain Injury Monitoring in Children with or without Congenital Heart Diseases

Abella

Varrica

Satriano

et al. 2015

CNSNDDT

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Perinatal asphyxia (PA) still constitutes a common complication involving a large number of infants with or without congenital heart diseases (CHD). PA affects 0.2-0.6% of full-term neonates, 20% of which suffer mortal hypoxic-ischemic encephalopathy, and among survivors 25% exhibit permanent consequences at neuropsychological level. Each year, about one third of 1000 live births underwent to surgical intervention in early infancy and/or are at risk for ominous outcome. Advances in brain monitoring, in anesthetic and cardiothoracic surgical techniques, including selective or total body cooling, cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest, have essentially reduced mortality expanding the possibility to address functional neurologic and cardiac outcomes in long-term survivors. However, open-heart surgery constitutes a time-frame of planned ischemia-reperfusion injury, which is a price to pay in the treatment or palliation of CHD. Infants who underwent heart surgery and non-CHD infants complicated by PA share similarities in their neurodevelopmental profile and a common form of brain damage due to hypoxic-ischemic injury. The purpose of the present review was to evaluate different mechanisms implicated in brain injury following CPB and PA and how it is possible to monitor such injury by means of available biomarkers (S100B protein, Activin A, Adrenomedullin).

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Why Does Perinatal Morbidity Increase

Cited by 5 publications

References 20 publications

Biochemical markers of perinatal brain damage

Biochemical markers of perinatal brain damage

New markers of neonatal neurology

Biochemical Markers for Brain Injury Monitoring in Children with or without Congenital Heart Diseases

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