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A recent study suggests that a blood test could accurately determine the source of brain damage in newborn infants and aid in determining the most effective treatment for them.
The study examined infants who suffered from a specific brain injury due to hypoxia, which is a condition where there is a reduced supply of oxygen.
The study discovered that identifiable markers in the blood can indicate the source of the injury and inform medical professionals if the infant is expected to benefit from cooling therapy, a commonly prescribed treatment for brain injury.
According to researchers at Imperial College London, their discoveries may eventually result in a straightforward exam that can rapidly detect brain injuries in newborns and aid in making treatment choices.
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Clinicians around the globe need to quickly determine the specific type of brain injury they are facing, and this is a current area of focus in our work.
The research encompassed infants from both low and middle-income nations (LMICs) and high-income countries (HICs).
A significant variation in gene activity was discovered between the two groups, indicating a potential disparity in the root cause of the brain injury.
The study suggests that newborn brain injury in less affluent countries may be caused by various factors, such as inadequate nourishment or infection.
In more affluent nations, it was common for one factor, such as birth complications, to be the primary cause.
Professor Sudhin Thayyil, the lead researcher from the department of brain sciences at Imperial, stated that the gene expression patterns observed in infants from LMICs were comparable to those seen in individuals with sleep apnea. This suggests that these babies may have experienced periods of low oxygen levels during pregnancy and delivery.
“We hypothesize that this may be caused by various chronic stressors experienced during pregnancy, such as inadequate nourishment or infection, as well as the natural process of labor and uterine contractions. These factors can result in decreased oxygen supply and ultimately damage to the baby’s brain.”
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We anticipated observing variations in genetic activity among infants in the groups, but did not anticipate such a significant difference.
“Conversely, gene expression patterns in infants from higher-income countries indicated a singular, abrupt reason for brain injury, such as birth complications like maternal bleeding, resulting in a sudden decrease in oxygen levels in the fetus.”
Professor Thayyil stated that it is crucial for clinicians worldwide to quickly determine the type of brain injury they are treating, and this is a current focus of their work.
Hypoxic-Ischemic Encephalopathy (HIE) is a form of brain damage commonly known as birth asphyxia. This injury happens when a newborn’s brain does not receive sufficient oxygen either before or immediately after birth.
According to experts, it is a top contributor to mortality and disabilities worldwide, such as cerebral palsy, epilepsy, and sensory impairments, among infants born at full-term. This condition affects approximately three million newborns annually.
India, specifically in South Asia, has the highest number of cases globally.
Past studies in developing nations have indicated that whole-body cooling, a treatment method for the condition, may have negative effects on babies with HIE and potentially increase the likelihood of mortality.
The recent research sheds light on the reason for the varying reactions observed in the two groups of infants.
The causes of brain injury differ significantly between the two groups, with distinct characteristics. This also helps to elucidate why some infants respond positively to cooling treatment while others are negatively affected by it.
A study conducted by Imperial and its partners in South Asia involved 35 newborns diagnosed with HIE in a high-income country (Italy) and 99 newborns from low- and middle-income countries in South Asia (India, Sri Lanka, and Bangladesh).
Blood samples were collected immediately after delivery and the infants were evaluated at 18 months old.
Approximately 50% of infants in the South Asian group passed away or experienced severe disabilities, compared to 25% in the Italian group.
Professor Swati Manerkar, co-author of the study from Lokmanya Tilak Municipal Medical College in Mumbai, India, stated that they had anticipated variations in gene expression among the groups of babies, but were surprised by the significant differences observed.
“This clearly reveals that the causes of brain injury in the two groups are distinct and possess varying characteristics. This also aids in understanding why certain infants benefit from cooling therapy while others are negatively affected.”
The scientists emphasized that the variances were not tied to race, but instead to economic factors.
The results were published in the JAMA Network Open journal.
Source: independent.co.uk
