Perinatal infection, fetal inflammatory response, white matter damage, and cognitive limitations in children born preterm

Dammann, Olaf; Kuban, Karl; Leviton, Alan

doi:10.1002/mrdd.10005

Cited by 226 publications

(146 citation statements)

References 62 publications

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“…27 Combined, these two processes result in morphological white matter lesions and the impairment of myelination, one of the most serious complications of WMD in preterm infants. 28 Pathogenetically important is the fact that the immature fetal brain becomes sensitized to hypoxia-ischemia during antenatal infection. There is a sensitization of the fetal brain to a subsequent hypoxic-ischemic insult after intraperitoneal or intracisternal application of bacterial endotoxins.…”

Section: Multiorgan Overviewmentioning

confidence: 99%

Chorioamnionitis: a multiorgan disease of the fetus?

et al. 2010

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The bacterial infection of chorion and amnion is a common finding in premature delivery and is referred to as chorioamnionitis. As the mother rarely shows symptoms of a systemic inflammation, the course of chorioamnionitis is frequently asymptomatic and chronic. In contrast, the fetal inflammatory response syndrome represents a separate phenomenon, including umbilical inflammation and increased serum levels of proinflammatory cytokines in the fetus. Ascending maternal infections frequently lead to systemic fetal inflammatory reaction. Clinical studies have shown that antenatal exposure to inflammation puts the extremely immature neonates at a high risk for worsening pulmonary, neurological and other organ development. Interestingly, the presence of chorioamnionitis is associated with a lower rate of neonatal mortality in extremely immature newborns. In the following review, the pathogeneses of inflammation-associated perinatal morbidity are outlined. The concept of fetal multiorganic disease during intrauterine infection is introduced and discussed.

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Section: Multiorgan Overviewmentioning

confidence: 99%

Chorioamnionitis: a multiorgan disease of the fetus?

et al. 2010

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“…It is possible that maturation is actually accelerated by the extrauterine environment. At the same time, the preterm infant is at risk of serious insults to the brain: from maternal infections, high vulnerability to inflammatory mechanisms (Dammann and Leviton, 1997;Dammann et al, 2002;du Plessis and Volpe, 2002), and oxidative processes (Haynes et al, 2005), as well as other perinatal complications . When studying groups of typical preterm infants, the effects of prematurity per se may be masked by those associated with neurological risk factors.…”

Section: Introductionmentioning

confidence: 99%

Accelerated cerebral white matter development in preterm infants: A voxel-based morphometry study with diffusion tensor MR imaging

et al. 2008

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Twenty-seven preterm infants were compared to 10 full-term infants at term equivalent age using a voxel-based analysis of diffusion tensor imaging of the brain. Preterm infants exhibited higher fractional anisotropy values, which may suggest accelerated maturation, in the location of the sagittal stratum. While some earlier findings in preterm infants have suggested developmental delays, the results of this study are more consistent with accelerated white matter development, possibly as a result of increased sensorimotor stimulation in the extrauterine environment. These results are the first to suggest that the increased intensity of stimulation associated with preterm birth may advance the process of white matter maturation in the human brain. Questions remain about whether these findings reflect acceleration of the process of white matter maturation generally, or localized alterations induced specifically by activity in affected pathways.

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“…Vários estudos apontam diferentes fatores perinatais associando-se com maior gravidade da LSB cerebral neonatal: displasia bro n c o p u l m o n a r, transfusão de concentrado de hemácias 2 1 , infecção, hipotiro x i n emia 22 , hipotensão 23,24 , baixo escore de Apgar no prim e i ro e quinto minutos, persistência do canal art e r i a l , d e s c o n f o rto respiratório precoce, insuficiência re s p ir a t ó r i a 2 5 , pré-eclampsia 2 6 , hipocarbia 2 7 , hipern a t re m i a , c i ru rg i a s 2 8 , enquanto anemia 2 1 , uso de cort i c ó i d e s p r é -n a t a l 2 9 e pré-eclampsia 2 2 seriam pro t e t o res. A maioria destes estudos, contudo, não controlou o peso de nascimento por faixas, ou, quando contro l a d o , compararam somente o risco de desenvolver ecolucência (forma mais grave).…”

Section: Peso (%)unclassified

Peso de nascimento como preditor para a gravidade da lesão da substância branca cerebral neonatal

Argollo

Lessa

Ribeiro³

et al. 2006

Arq. Neuro-Psiquiatr.

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RESUMO -Para analisar a associação entre fatores natais com a gravidade da lesão da substância branca (LSB) cerebral neonatal, controlando o peso de nascimento, identificaram os neonatos pela ultra-sonografia craniana, que foram divididos em: aqueles com evolução da LSC para resolução da imagem ao ultra-som (menor gravidade) e, aqueles que evoluiram com formação de cistos e/ou ventriculomegalia e/ou hemorr a g i a (maior gravidade). Doze variáveis (hiponatremia, anemia, infecção, retinopatia, displasia bro n c o p u l m o n a r, hipoalbuminemia, persistência do canal arterial, audiometria alterada, desconforto respiratório pre c o c e , peso de nascimento <2500g, peso por categoria e prematuridade) tiveram diferenças entre os dois gru p o s (p<0,05), sendo que 9 (hiponatremia, infecção, retinopatia, hipoalbuminemia, persistência do canal art e r i a l , d e s c o n f o rt o respiratório precoce, baixo peso, prematuridade e peso por categorias) se mantiveram estatisticamente diferentes (p<0,01) após análise por re g ressão logística. Quando analisadas por categoria de peso de nascimento, nenhuma variável demonstrou significância estatística. O estudo sugere que o peso de nascimento é o maior fator -provavelmente o único -associado com gravidade da LSB cerebral neonatal.PA L AV R A S -C H AVE: recém nascido, lesão da substância branca cerebral, leucomalácia periventricular, infart o da substância branca periventricular, peso de nascimento. Birth weight as predictor for the severity of neonatal brain white matter lesionABSTRACT -To analyze the association of natal factors with the severity of neonatal brain white matter lesion (WML) by controlling the birth weight, we identified newborns with WML who were divided into: those with WML evolution towards resolution of the ultrasound image (less severe), and those who evolved with cist formation and/or ventriculomegalia and/or hemorrhage (greater severity). There were diff e re n c e s among the twelve variables (hyponatremia, anemia, infection, re t i n o p a t h y, bro n c o p u l m o n a ry dysplasia, hypoalbuminemia, persistence of the arterial canal, altered audiometry, early re s p i r a t o ry distress, birt h weigh below 2,500 g, weight per category, and prematurity) between the two groups (p<0.05), being that nine variables (hyponatremia, infection, retinopathy, hypoalbuminemia, persistence of the arterial canal, early re s p i r a t o ry distress, low weight, pre m a t u r i t y, and weight per category) remained statistically diff e re n t (p<0.01) after the logistic re g ression analysis. When the variables were analyzed by birth weight category none of them presented statistical significance. This study suggests that birth weight is the major factorlikely the only one -associated to the severity of neonatal brain white matter lesion.KEY WORDS: newborn, brain white matter lesion, periventricular leukomalacia, periventricular white matter infarction, birth weight.A lesão da substância branca (LSB) é a lesão cerebral mais freqüente no neonato pré-termo e a te...

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Perinatal infection, fetal inflammatory response, white matter damage, and cognitive limitations in children born preterm

Cited by 226 publications

References 62 publications

Chorioamnionitis: a multiorgan disease of the fetus?

Chorioamnionitis: a multiorgan disease of the fetus?

Accelerated cerebral white matter development in preterm infants: A voxel-based morphometry study with diffusion tensor MR imaging

Peso de nascimento como preditor para a gravidade da lesão da substância branca cerebral neonatal

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