The fetus at the tipping point: modifying the outcome of fetal asphyxia

Simerdeep K. Dhillon, Christopher A. Lear, Robert Galinsky, Guido Wassink, Joanne O. Davidson, Sandra E. Juul, Nicola J. Robertson, Alistair J Gunn, Laura Bennet

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute hypoxia–ischaemia is a major contributor to injury. It is now well established that the severity of injury after hypoxia–ischaemia is determined by a dynamic balance between injurious and protective processes. In addition, mothers who are at risk of premature delivery have high rates of diabetes and antepartum infection/inflammation and are almost universally given treatments such as antenatal glucocorticoids and magnesium sulphate to reduce the risk of death and complications after preterm birth. We review evidence that these common factors affect responses to fetal asphyxia, often in unexpected ways. For example, glucocorticoid exposure dramatically increases delayed cell loss after acute hypoxia–ischaemia, largely through secondary hyperglycaemia. This critical new information is important to understand the effects of clinical treatments of women whose fetuses are at risk of perinatal asphyxia.
Original languageEnglish
Pages (from-to)1-22
Number of pages22
JournalThe Journal of Physiology
DOIs
Publication statusAccepted/In press - 2018
Externally publishedYes

Cite this

Dhillon, S. K., Lear, C. A., Galinsky, R., Wassink, G., Davidson, J. O., Juul, S. E., ... Bennet, L. (Accepted/In press). The fetus at the tipping point: modifying the outcome of fetal asphyxia. The Journal of Physiology, 1-22. https://doi.org/10.1113/JP274949
Dhillon, Simerdeep K. ; Lear, Christopher A. ; Galinsky, Robert ; Wassink, Guido ; Davidson, Joanne O. ; Juul, Sandra E. ; Robertson, Nicola J. ; Gunn, Alistair J ; Bennet, Laura. / The fetus at the tipping point : modifying the outcome of fetal asphyxia. In: The Journal of Physiology. 2018 ; pp. 1-22.
@article{eb36f798279b4ab4bc58387119120f83,
title = "The fetus at the tipping point: modifying the outcome of fetal asphyxia",
abstract = "Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute hypoxia–ischaemia is a major contributor to injury. It is now well established that the severity of injury after hypoxia–ischaemia is determined by a dynamic balance between injurious and protective processes. In addition, mothers who are at risk of premature delivery have high rates of diabetes and antepartum infection/inflammation and are almost universally given treatments such as antenatal glucocorticoids and magnesium sulphate to reduce the risk of death and complications after preterm birth. We review evidence that these common factors affect responses to fetal asphyxia, often in unexpected ways. For example, glucocorticoid exposure dramatically increases delayed cell loss after acute hypoxia–ischaemia, largely through secondary hyperglycaemia. This critical new information is important to understand the effects of clinical treatments of women whose fetuses are at risk of perinatal asphyxia.",
author = "Dhillon, {Simerdeep K.} and Lear, {Christopher A.} and Robert Galinsky and Guido Wassink and Davidson, {Joanne O.} and Juul, {Sandra E.} and Robertson, {Nicola J.} and Gunn, {Alistair J} and Laura Bennet",
year = "2018",
doi = "10.1113/JP274949",
language = "English",
pages = "1--22",
journal = "The Journal of Physiology",
issn = "0022-3751",
publisher = "Wiley-Blackwell",

}

Dhillon, SK, Lear, CA, Galinsky, R, Wassink, G, Davidson, JO, Juul, SE, Robertson, NJ, Gunn, AJ & Bennet, L 2018, 'The fetus at the tipping point: modifying the outcome of fetal asphyxia' The Journal of Physiology, pp. 1-22. https://doi.org/10.1113/JP274949

The fetus at the tipping point : modifying the outcome of fetal asphyxia. / Dhillon, Simerdeep K.; Lear, Christopher A.; Galinsky, Robert; Wassink, Guido; Davidson, Joanne O.; Juul, Sandra E.; Robertson, Nicola J.; Gunn, Alistair J; Bennet, Laura.

In: The Journal of Physiology, 2018, p. 1-22.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - The fetus at the tipping point

T2 - modifying the outcome of fetal asphyxia

AU - Dhillon, Simerdeep K.

AU - Lear, Christopher A.

AU - Galinsky, Robert

AU - Wassink, Guido

AU - Davidson, Joanne O.

AU - Juul, Sandra E.

AU - Robertson, Nicola J.

AU - Gunn, Alistair J

AU - Bennet, Laura

PY - 2018

Y1 - 2018

N2 - Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute hypoxia–ischaemia is a major contributor to injury. It is now well established that the severity of injury after hypoxia–ischaemia is determined by a dynamic balance between injurious and protective processes. In addition, mothers who are at risk of premature delivery have high rates of diabetes and antepartum infection/inflammation and are almost universally given treatments such as antenatal glucocorticoids and magnesium sulphate to reduce the risk of death and complications after preterm birth. We review evidence that these common factors affect responses to fetal asphyxia, often in unexpected ways. For example, glucocorticoid exposure dramatically increases delayed cell loss after acute hypoxia–ischaemia, largely through secondary hyperglycaemia. This critical new information is important to understand the effects of clinical treatments of women whose fetuses are at risk of perinatal asphyxia.

AB - Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute hypoxia–ischaemia is a major contributor to injury. It is now well established that the severity of injury after hypoxia–ischaemia is determined by a dynamic balance between injurious and protective processes. In addition, mothers who are at risk of premature delivery have high rates of diabetes and antepartum infection/inflammation and are almost universally given treatments such as antenatal glucocorticoids and magnesium sulphate to reduce the risk of death and complications after preterm birth. We review evidence that these common factors affect responses to fetal asphyxia, often in unexpected ways. For example, glucocorticoid exposure dramatically increases delayed cell loss after acute hypoxia–ischaemia, largely through secondary hyperglycaemia. This critical new information is important to understand the effects of clinical treatments of women whose fetuses are at risk of perinatal asphyxia.

U2 - 10.1113/JP274949

DO - 10.1113/JP274949

M3 - Review Article

SP - 1

EP - 22

JO - The Journal of Physiology

JF - The Journal of Physiology

SN - 0022-3751

ER -