Study: “Brain Cooling” After Birth may Reduce Newborns’ Risk of Cerebral Palsy

Brain CoolingBirth asphyxia is when infants don't get enough oxygen during the birthing process causing damage to their body, particularly their brain. This lack of oxygen could lead to brain damage or even death. Treatment is usually ineffective. However, decades of research and recent technology may change this. Xenon gas and brain cooling have the potential to increase infants' odds of surviving brain asphyxia and reduce their risk of developing conditions like cerebral palsy.

Cooling Infant Brains and Improving Their Survival Rates

According to a New England Journal of Medicine study conducted by researchers at London's Imperial College, "brain cooling" after birth may drastically improve infants' survival rates.

The study builds on an extensive body of research to make this claim. Hypoxic-ischemic (HI) brain injury, or an injury caused by a lack of oxygen to the brain, affects one in every six live human births. This type of injury has a mortality rate of 15% to 20%. In addition, a quarter of HI brain injury survivors spend the rest of their lives with permanent and severe disabilities.

This study suggests that infants who had their brains "cooled" after birth had a 25% greater chance of survival than those who did not undergo this process. This "brain cooling therapy" involved placing a "coolcap" hat filled with water on the newborn baby's head. This helps reduce brain swelling as a result of the asphyxia.

In addition, the process lowers the baby's metabolic rate, which in turn allows the baby's organs to function with less oxygen. This process is helpful because it stabilizes and protects the baby from internal damage while doctors are performing additional life-saving procedures.

Birth Asphyxia and Cerebral Palsy

A severe lack of oxygen to the brain immediately following childbirth cause HI brain injuries. When the infants survive these injuries, they may suffer severe brain damage that manifests itself in underdevelopment, cognitive delays, and mobility impairments. These disabilities can become more severe and obvious as the infant grows.

Newborns can survive without oxygen for brief periods of time. During the childbirth process, these infants will have to endure losing their sources of oxygen while they're exiting the birth canal. However, if this asphyxia lasts for too long, the baby can suffer from severe brain damage.

Complications from HI injuries include:

  • Developmental delays
  • Neurodevelopmental delays
  • Cognitive disabilities
  • Epilepsy
  • Motor skills impairment

Usually, these defects aren't apparent until three or four years of age. However, the effects can be permanent and life-altering.

A number of causes can trigger birth asphyxia. A few of which are:

  • Medical negligence
  • Poor blood flow to the baby's brain during birth
  • Pressure to the infant's skull
  • Uterine rupture
  • Increased stress from labor
  • Low oxygen levels in the blood
  • Complications related to the cardiac system
  • Umbilical cord complications
  • Trauma
  • Hemorrhaging
  • Complications with the placenta
  • Poor oxygen supply or interrupted breathing
  • A prolapsed umbilical cord

Medical professionals have long believed this asphyxia was the direct cause of cerebral palsy. However, advanced research has shown that only 9% of cerebral palsy cases are the result of HI injuries. Premature birth and other complications during and after labor are the leading causes of this condition.

An Extensive Body of Research

Research is hopeful, however. Dr. Denis Azzopardi in an interview with The Independent, who served as the lead researcher for the study, explains, "Our study builds on a 20-year body of research but gives, for the first time, irrefutable proof that cooling can be effective in reducing brain damage after birth asphyxia."

According to the same interview, doctors first used brain cooling in the 19th century to tend to soldiers' injuries. In the 1950s, obstetricians used a similar technique as a means to resuscitate infants.

In Azzopardi's study, researchers studied 325 babies who experienced asphyxiation. Half of these infants received brain cooling treatment within six hours of birth. During the cooling process, medical professionals kept these infants' body temperatures at 3C to 4C below normal for the next three days. Of the infants who underwent brain cooling, 44% recovered with no brain damage. In contrast, only 28% of infants who did not receive brain cooling treatment recovered with no brain damage.

Helping Hypoxic Brain Injuries

In addition to brain cooling, a 2010 BBC report suggests that xenon gas technology may also help babies suffering from asphyxia survive at greater rates. The administration of xenon gas during the brain cooling process could help restore infants' respiratory systems.

According to a 2008 study published in the National Institutes of Health, the combination of xenon gas treatment and brain cooling offers greater protection to infants suffering from hypoxia than either treatment can accomplish alone. The paper states that the combined treatment "is an attractive combination therapy… to improve the otherwise bleak outcome from neonatal Hypoxic/Ischemic [brain injury]."

Birth asphyxia cases are extremely prevalent in the United States and worldwide. Given their devastating consequences for families and the children themselves, further research into this treatment is crucial.

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