Oxygen deprivation at birth: a new type of ‘gas and air’ might relieve mothers’ labour pains and protect babies
This research was completed on 31 August 2011
Published on 10 May 2012
Worldwide, nearly one quarter of babies who die within a month of birth lose their lives to a problem called birth asphyxia1,2 – oxygen deprivation and a reduced blood supply to the brain around the time of birth that can cause brain damage. Dr Daqing Ma’s laboratory work, at Imperial College London, suggests a new type of ‘gas and air’ might both relieve mothers’ labour pains and save babies’ lives. He is continuing his studies and planning clinical trials.
What's the problem and who does it affect?
Around one in every 1,000 newborn babies in the UK dies or suffers severe brain damage, often with devastating consequences, due to birth asphyxia – that’s 700 babies every year.3 The problem also causes an estimated 250 stillbirths.4
Birth asphyxia is in fact a major cause of death and illness in babies and children worldwide. The World Health Organisation estimates it is the fifth largest cause of death in children under five.5
Birth asphyxia can result from a variety of things during childbirth, including problems with the placenta or umbilical cord. Immediately after birth, it can be caused by an obstruction in the airways.
“If a baby develops birth asphyxia during childbirth, then his or her life is in immediate danger,” explains Dr Ma. “Sadly, many babies are stillborn or die soon after birth. Babies who survive can develop life-long disabilities, such as cerebral palsy, learning disabilities, deafness and epilepsy, which can severely affect quality of life for these babies and their families.”
During labour, the only way to help babies with birth asphyxia is to deliver them urgently, by caesarean section for example. ‘New ways to help babies with birth asphyxia during childbirth are urgently needed, says Dr Ma.
What did the project achieve?
Dr Ma has gathered laboratory evidence that suggests certain anaesthetics might help babies with birth asphyxia.
“Gas and air is widely used during childbirth to relieve mothers’ labour pains,” explains Dr Ma. “It contains an inhaled anaesthetic called nitrous oxide. I have gathered preliminary evidence in a laboratory model, which suggests that two other anaesthetic gases, called xenon and sevoflurane, might have the power not only to relieve mothers’ labour pains, but also to protect babies from the effects of birth asphyxia. I would like to move this research forward from bench to bedside and I am planning clinical trials.” Action Medical Research is funding Dr Ma’s ongoing work.
Both xenon and sevoflurane are already being used safely on a daily basis to provide pain relief in other circumstances, meaning extensive data are available on their safety. Indeed xenon has been in use since the 1950s.
“If the gases prove safe and effective in clinical trials, they could provide a simple, cost-effective way to provide pain relief during childbirth, suitable for widespread use worldwide,” says Dr Ma. “Crucially, they might have the added benefit of protecting babies from the brain damage, death and life-long disability that birth asphyxia can cause.”
What are the researchers' credentials?
|Project Leader||Dr Daqing Ma MD, PhD|
|Location||Department of Anaesthetics, Chelsea & Westminster Hospital, Imperial College, London|
|Grant awarded||30 October 2008|
|Start date||1 June 2009|
|End date||31 August 2011|
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Dr Ma is an established leader in researching how anaesthetics work and has extensive experience of caring for mothers and babies around the time of birth. His research has been published in several leading journals and the laboratories where he works contain state-of-the-art equipment that is ideally suited to this project.
1. Lawn JE, et al. 4 million neonatal deaths: When? Where? Why? Lancet 2005; 365(9462); 891-900.
2. Bryce J, et al. WHO estimates of the causes of death in children. Lancet 2005; 365:1147-52.
3. McGuire W. Perinatal asphyxia. ClinicalEvidence (Online) 2007; 2007: 0320. Published online 2007, November 7. Website accessed 30 January 2012. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943784/
4. CMACE, Perinatal mortality 2008, London 2010.
5. Bryce J, et al, WHO Child Health Epidemiology Reference Group. WHO estimates of the causes of death in children. Lancet 2005; 365(9465):1147-52.