Antenatal prevention of cerebral palsy and childhood disability: is the impossible possible?

Stacey J. Ellery, Meredith Kelleher, Peta Grigsby, Irina Burd, Jan B. Derks, Jon Hirst, Suzanne L. Miller, Larry S. Sherman, Mary Tolcos, David W. Walker

    Research output: Contribution to journalReview articlepeer-review

    7 Scopus citations

    Abstract

    This review covers our current knowledge of the causes of perinatal brain injury leading to cerebral palsy-like outcomes, and argues that much of this brain damage is preventable. We review the experimental evidence that there are treatments that can be safely administered to women in late pregnancy that decrease the likelihood and extent of perinatal brain damage that occurs because of acute and severe hypoxia that arises during some births, and the additional impact of chronic fetal hypoxia, infection, inflammation, growth restriction and preterm birth. We discuss the types of interventions required to ameliorate or even prevent apoptotic and necrotic cell death, and the vulnerability of all the major cell types in the brain (neurons, astrocytes, oligodendrocytes, microglia, cerebral vasculature) to hypoxia/ischaemia, and whether a pan-protective treatment given to the mother before birth is a realistic prospect. (Figure presented.).

    Original languageEnglish (US)
    Pages (from-to)5593-5609
    Number of pages17
    JournalJournal of Physiology
    Volume596
    Issue number23
    DOIs
    StatePublished - Dec 1 2018

    Keywords

    • Oxidative stress
    • cerebral palsy
    • neuroprotection
    • perinatal brain damage
    • prophylaxis

    ASJC Scopus subject areas

    • Physiology

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