scholarly journals Neuroscience meets nurture: challenges of prematurity and the critical role of family-centred and developmental care as a key part of the neuroprotection care bundle

2021 ◽  
pp. fetalneonatal-2020-319450
Author(s):  
Roopali Soni ◽  
Charlotte Tscherning Wel-Wel ◽  
Nicola J Robertson
Keyword(s):  
Premature Birth ◽  
Critical Role ◽  
Fetal Brain ◽  
Intraventricular Haemorrhage ◽  
Care Bundle ◽  
Neurodevelopmental Outcomes ◽  
Perinatal Medicine ◽  
Developmental Care ◽  
Fetal Brain Development

Advances in neonatal–perinatal medicine have resulted in increased survival at lower gestations. Although the incidence of germinal matrix haemorrhage-intraventricular haemorrhage and cystic periventricular leucomalacia is reducing, a new phenotype of preterm brain injury has emerged consisting of a combination of destructive and dysmaturational effects. Consequently, severe neurological disability is reported at a lower rate than previously, but the overall morbidity associated with premature birth continues to present a large global burden and contributes significantly to increased financial costs to health systems and families. In this review, we examine the developmental milestones of fetal brain development and how preterm birth can disrupt this trajectory. We review common morbidities associated with premature birth today. Although drug-based and cell-based neuroprotective therapies for the preterm brain are under intense study, we outline basic, sustainable and effective non-medical, family-centred and developmental care strategies which have the potential to improve neurodevelopmental outcomes for this population and need to be considered part of the future neuroprotection care bundle.

scholarly journals Neuroplacentology in congenital heart disease: placental connections to neurodevelopmental outcomes

2021 ◽  
Author(s):  
Rachel L. Leon ◽  
Imran N. Mir ◽  
Christina L. Herrera ◽  
Kavita Sharma ◽  
Catherine Y. Spong ◽  
...  
Keyword(s):  
Brain Development ◽  
Congenital Heart ◽  
Fetal Brain ◽  
In Utero ◽  
Structure And Function ◽  
Brain Growth ◽  
Neurodevelopmental Outcomes ◽  
Fetal Brain Development ◽  
And Function

Abstract Children with congenital heart disease (CHD) are living longer due to effective medical and surgical management. However, the majority have neurodevelopmental delays or disorders. The role of the placenta in fetal brain development is unclear and is the focus of an emerging field known as neuroplacentology. In this review, we summarize neurodevelopmental outcomes in CHD and their brain imaging correlates both in utero and postnatally. We review differences in the structure and function of the placenta in pregnancies complicated by fetal CHD and introduce the concept of a placental inefficiency phenotype that occurs in severe forms of fetal CHD, characterized by a myriad of pathologies. We propose that in CHD placental dysfunction contributes to decreased fetal cerebral oxygen delivery resulting in poor brain growth, brain abnormalities, and impaired neurodevelopment. We conclude the review with key areas for future research in neuroplacentology in the fetal CHD population, including (1) differences in structure and function of the CHD placenta, (2) modifiable and nonmodifiable factors that impact the hemodynamic balance between placental and cerebral circulations, (3) interventions to improve placental function and protect brain development in utero, and (4) the role of genetic and epigenetic influences on the placenta–heart–brain connection. Impact Neuroplacentology seeks to understand placental connections to fetal brain development. In fetuses with CHD, brain growth abnormalities begin in utero. Placental microstructure as well as perfusion and function are abnormal in fetal CHD.

scholarly journals Developmental programming of brain and behavior by perinatal diet: focus on inflammatory mechanisms

2014 ◽  
Vol 16 (3) ◽  
pp. 307-320 ◽  
Keyword(s):  
Brain Development ◽  
Maternal Obesity ◽  
Fetal Brain ◽  
High Fat ◽  
High Fat Diets ◽  
Fetal Brain Development ◽  
Brain And Behavior ◽  
Fat Diets ◽  
And Behavior

Obesity is now epidemic worldwide. Beyond associated diseases such as diabetes, obesity is linked to neuropsychiatric disorders such as depression. Alarmingly maternal obesity and high-fat diet consumption during gestation/lactation may "program" offspring longterm for increased obesity themselves, along with increased vulnerability to mood disorders. We review the evidence that programming of brain and behavior by perinatal diet is propagated by inflammatory mechanisms, as obesity and high-fat diets are independently associated with exaggerated systemic levels of inflammatory mediators. Due to the recognized dual role of these immune molecules (eg, interleukin [IL]-6, 11-1β) in placental function and brain development, any disruption of their delicate balance with growth factors or neurotransmitters (eg, serotonin) by inflammation early in life can permanently alter the trajectory of fetal brain development. Finally, epigenetic regulation of inflammatory pathways is a likely candidate for persistent changes in metabolic and brain function as a consequence of the perinatal environment.

The Changing Role of Maternal Thyroid Hormone in Fetal Brain Development

2008 ◽  
Vol 32 (6) ◽  
pp. 380-386 ◽  
Author(s):  
Gabriella Morreale de Escobar ◽  
Susana Ares ◽  
Pere Berbel ◽  
María Jesus Obregón ◽  
Francisco Escobar del Rey
Keyword(s):  
Thyroid Hormone ◽  
Brain Development ◽  
Fetal Brain ◽  
Fetal Brain Development ◽  
Maternal Thyroid ◽  
Changing Role

scholarly journals Fetal innate immunity contributes to the induction of atypical behaviors in a mouse model of maternal immune activation

2020 ◽  
Author(s):  
Eva K. Nichols ◽  
Hsiu-Chun Chuang ◽  
Matthew T. Davis ◽  
Kristina M. Geiger ◽  
Rick Z. Li ◽  
...  
Keyword(s):  
Innate Immunity ◽  
Immune Activation ◽  
Repetitive Behavior ◽  
Fetal Brain ◽  
Toll Like Receptor ◽  
Neurodevelopmental Outcomes ◽  
Behavioral Phenotypes ◽  
Maternal Immune Activation ◽  
Fetal Brain Development ◽  
Adapter Molecule

SummaryMaternal immune activation (MIA) increases likelihood of altered neurodevelopmental outcomes. Maternal cytokines are proposed to affect fetal brain development in mice; however, the contribution of fetal immunity to neurodevelopmental disorders is largely unexplored. Here, we show that MIA mediated by Toll-like receptor 3 (TLR3), but not other TLRs, induces a specific set of behavioral phenotypes including decreased sociability and increased restricted repetitive behavior in offspring. Accordingly, these behavioral phenotypes were absent when offspring were deficient for Trif, the downstream adapter molecule of TLR3. Using single-cell RNA sequencing, we identified clusters of border-associated macrophages that were significantly enriched in the fetal brain following TLR3-MIA, and these clusters were diminished in Trif−/− fetal brains.Moreover, we found that triggering TLR3-TRIF in offspring can occur through transplacental viral infection, resulting in altered behavioral phenotypes. Collectively, our data indicate that fetal innate immunity contributes to MIA-induced atypical behaviors in mice.

scholarly journals Functional Test for Fetal Brain: The Role of KANET Test

2013 ◽  
Vol 7 (4) ◽  
pp. 385-399 ◽  
Author(s):  
Panagiotis Antsaklis ◽  
Sebija Izetbegovic
Keyword(s):  
Brain Development ◽  
Full Range ◽  
Fetal Brain ◽  
In Utero ◽  
Functional Test ◽  
Postnatal Life ◽  
Perinatal Medicine ◽  
4D Ultrasound ◽  
Upper And Lower Extremities

ABSTRACT Defining normal and abnormal fetal neurological function in utero in order to better predict antenatally which fetuses are at risk for adverse neurological outcome has remained a great challenge in perinatal medicine. Fetal behavioral patterns have been considered as indicators of fetal brain development. It has been suggested that the assessment of fetal behavior in different periods of gestation may make possible the distinction between normal and abnormal brain development. Advances in ultrasound technology and particularly the introduction of real time four-dimensional (4D) ultrasonography, allowed direct observation of in utero life and offered a new insight for the assessment of fetal behavior. Fetal behavioral movements, the full range of facial expressions and mobility of fetal upper and lower extremities and fingers can be clearly visualized with 4D ultrasound. A new scoring system for the assessment of fetal neurobehavior based on prenatal assessment of the fetus with 4D sonography has been developed based on the same technique that neonatologists assess newborns during the first days of their postnatal life. This overview focuses on the study of fetal behavior and neurological assessment with 4D ultrasound. How to cite this article Antsaklis P, Kurjak A, Izetbegovic S. Functional Test for Fetal Brain: The Role of KANET Test. Donald School J Ultrasound Obstet Gynecol 2013;7(4):385-399.

scholarly journals The fetal brain: role of progesterone and allopregnanolone

2016 ◽  
Vol 27 (1) ◽  
Author(s):  
Nicola Pluchino ◽  
Marinella Russo ◽  
Andrea R. Genazzani
Keyword(s):  
Intrauterine Growth Restriction ◽  
Perinatal Care ◽  
Critical Role ◽  
Fetal Brain ◽  
Protective Role ◽  
Active Metabolites ◽  
Maternal Brain ◽  
Potential Applications ◽  
The Impact

AbstractProgesterone and allopregnanolone have crucial and different roles in brain development, function and recovery after injury. Pregnancy is characterized by an increased synthesis of progesterone and its neuro-active metabolites by the placenta, maternal and fetal brain. This supports the critical role of these steroids in maternal brain adaptation during pregnancy and development of the fetal brain. Moreover, allopregnanolone may play a brain-protective role during complications of pregnancy, complications of pregnancy, such as preterm delivery or intrauterine growth restriction (IUGR), by reducing the impact of hypoxia and excitotoxic brain damage or impairment myelination. Behavioral consequences of altered progesterone/allopregnanolone fetal brain programming have also been hypothesized, although further evidence is needed. New potential applications of allopregnanolone as a treatment strategy have also been proposed, addressing unmet clinical needs in perinatal care.

scholarly journals Microorganisms in the Placenta: Links to Early-Life Inflammation and Neurodevelopment in Children

2019 ◽  
Vol 32 (3) ◽  
Author(s):  
Martha Scott Tomlinson ◽  
Kun Lu ◽  
Jill R. Stewart ◽  
Carmen J. Marsit ◽  
T. Michael O’Shea ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
Fetal Brain ◽  
Later Life ◽  
Microbial Infection ◽  
Neurodevelopmental Outcomes ◽  
Intrauterine Environment ◽  
Childhood Health ◽  
Placental Function ◽  
Neurological Outcomes ◽  
Fetal Brain Development

SUMMARY Prenatal exposure to various stressors can influence both early and later life childhood health. Microbial infection of the intrauterine environment, specifically within the placenta, has been associated with deleterious birth outcomes, such as preterm birth, as well as adverse neurological outcomes later in life. The relationships among microorganisms in the placenta, placental function, and fetal development are not well understood. Microorganisms have been associated with perinatal inflammatory responses that have the potential for disrupting fetal brain development. Microbial presence has also been associated with epigenetic modifications in the placenta, as well other tissues. Here we review research detailing the presence of microorganisms in the placenta and associations among such microorganisms, placental DNA methylation, perinatal inflammation, and neurodevelopmental outcomes.

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