The following is a sponsored post for David Christensen of Christensen Law
Infants are made for the trek from womb to world. Fontanelles, the soft spots on a baby’s head, allow the skull to flex so the baby can pass through the birth canal, though you’re in good company if you wonder if a child can suffer brain damage during birth. The biggest concern, however, isn’t in the shape of a child’s head or the flexibility of the fontanelles: Every year, thousands of newborns suffer complications during birth – and pregnancy, too – that deprive their brains of oxygen and nutrient-rich blood, resulting in a brain injury.
The deprivation of oxygen and blood to the brain that an infant can experience results in a condition called hypoxic ischemic encephalopathy (HIE), and this affliction can lead to long-term neurological problems like learning disabilities, cerebral palsy, and even death, according to the Waisman Center at the University of Wisconsin-Madison. And now researchers are closer to understanding why male infants are far more vulnerable to developing HIE than females.
The Protein That Offers Extra Protection to Little Girls
Baby girls are better protected from the HIE brain injury because a particular protein – estrogen receptor a (ERa) – found in the brains of both male and female mice is present at a higher level in females. This discovery was published in the journal eNeuro, and the study was led by Pelin Cengiz, associate professor in the Department of Pediatrics at the university. The researchers were determined to learn how ERa bestows its gender-specific protective effects.
“People often think that biological sex differences start to arise only after puberty, but they actually start in the womb and persist until the tomb,” says Cengiz, paraphrasing a 1999 statement by the Institute of Medicine. “So, treatment approaches that may work for newborn boys may not work for girls, and vice versa. We need to get it right to develop effective therapies.”
“Under normal circumstances, the brains of male and female mice have similar amounts of ERa,” says Cengiz, who studied a drug that is known to protect female but not male newborn mice from the effects of brain injury caused by HIE. The drug turns on protective effects in the brain in response to oxygen deprivation and reduced blood flow, but the ERa protein must be present in the mouse to begin with for this cascade to take place. Understanding these elements can help researchers in developing therapies that can help newborns – boys and girls alike – recover from HIE and live functional lives, though this drug and therapy discovery is a long way off for human infants.
Causes of HIE and Brain Damage in Newborns
While a newborn can compensate for depleted oxygen for brief periods of time during birth, brain tissue will be destroyed if the asphyxia lasts for too long. HIE affects 20 out of every 1,000 full-term births, according to the Florida Neonatal Neurologic Network, and in premature babies 60 percent of all live births have HIE, often occurring after delivery because of infections, low blood pressure, cardiac or pulmonary disease, severe prematurity, and brain or skull trauma.
The conscientious mother-to-be wants to do everything she can to make sure her baby is protected in the womb, but there are many problems or medical complications beyond her control that can cause HIE during pregnancy, including maternal diabetes, preeclampsia, problems with blood circulation to the placenta, cardiac disease, lung malformations, fetal anemia, and congenital infections of the fetus.
During labor and delivery, additional complications come into play and may include low maternal blood pressure, prolonged late stages of labor, umbilical cord accidents, excessive bleeding from the placenta, abnormal fetal position, and a ruptured placenta or uterus.
And, as in so many situations, it can sometimes be difficult to identify the exact cause of the HIE. But if a baby exhibits low heart rate, poor muscle tone, bluish skin color, weak breathing, or meconium-stained amniotic fluid, these symptoms will be investigated immediately by the doctor and nurses in labor and delivery.
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David Christensen is a brain injury expert at Christensen Law in Ann Arbor and Southfield, Michigan. He represents victims with traumatic brain injuries against insurance companies.