Premature birth: what causes brain damage?
First published on 18 February 2010
Updated on 17 October 2014
What did the project achieve?
“The ultimate aim of our research is to develop new ways to protect premature and newborn babies from brain damage,” says Professor Henrik Hagberg of King’s College London. Such protection is badly needed, as brain damage can lead to lifelong problems including cerebral palsy, epilepsy and learning disabilities. It can also prove fatal.
Around 16,000 babies are born before 32 weeks of pregnancy each year in the UK.1,2 Babies born this early are at increased risk of developing brain damage.
Other things can put babies at risk too. For example, estimates suggest around one in every 1,000 newborn babies in the UK dies or suffers severe brain damage because of oxygen deprivation at birth.3
“Our work is improving understanding of the molecular processes that lead to brain damage in babies,” says Professor Hagberg. “Our findings in this project suggest that activation of immune cells in the brain leads to the production of a molecule called TRAIL, which kills brain cells by activating so-called ‘death receptors’ on the cells.”
This increased understanding could one day enable the development of new treatments that protect babies from brain damage, so sparing them from disability and saving their lives.”
This research was completed on 31 August 2013
Premature birth puts babies at increased risk of suffering brain damage, especially if they are born very early. More than half of babies who are born 10 weeks or more before their due date suffer brain damage.1 Sadly, some of these babies die and many others develop lifelong problems, such as cerebral palsy, epilepsy and learning disabilities. Researchers are investigating the molecular processes that lead to brain damage, with the ultimate hope of finding ways to prevent it.
What's the problem and who does it affect?
Tiny and vulnerable
Between 23 and 32 weeks of pregnancy, an unborn baby’s brain is at a critical stage of development. Babies who are born during this time are at a far greater risk of suffering brain damage than babies who are born around their due date.
Large numbers of babies are in fact born very early – latest figures show over 10,000 babies are born before 32 weeks of pregnancy each year in the UK.2,3
Currently, there is no cure for brain damage in premature babies. Sadly, some of the babies lose their fight for life. Many who survive go on to develop lifelong problems such as cerebral palsy, epilepsy and learning disabilities.
Brain damage following premature birth can be a serious and costly health issue for the sufferers, their families and society. Children with severe cerebral palsy, for example, often depend on their families for full-time care. The disability can have a substantial impact on the whole family’s well being. Sufferers often continue to have significant problems in adulthood and their quality of life can be severely compromised.
What is the project trying to achieve?
Why do brain cells die after premature birth?
The researchers are hoping to reveal important new information about what causes brain damage in babies who are born too soon.
Evidence suggests two factors can cause brain damage following premature birth:
- a reduced supply of oxygen and glucose to the brain
- inflammation caused by infection in the mother or baby.
The researchers suspect that these two factors might cause brain damage by activating a protein called Fas. They think that, when activated, Fas might trigger the death of special brain cells, called oligodendrocytes.
In an unborn baby’s developing brain, oligodendrocytes normally have the job of wrapping an insulating sheath, called myelin, around nerve fibres. The death of oligodendrocytes, leading to a disruption in myelination, seems to be a major contributor to brain damage following premature birth.
The researchers are investigating their ideas in the laboratory. They are also finding out whether substances that target Fas can prevent the death of oligodendrocytes and the subsequent brain damage, in a laboratory model.
What are the researchers' credentials?
|Project Leader||Professor H Hagberg PhD MD|
|Location||Division of Imaging Sciences and Biomedical Engineering, King's College London, The Rayne Institute, St Thomas' Hospital|
|Grant awarded||18 November 2009|
|Start date||1 September 2010|
|End date||31 August 2013|
|Grant code||SP4506, GN1764|
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Three research groups, each with considerable expertise in their relevant disciplines, are collaborating on this project. Dr Deanna Taylor, the Project Leader, has extensive expertise in the molecular processes that lead to brain injury in newborn babies and has made several significant contributions to the field. Her research was the first to report that mild hypothermia (cooling) can protect against brain injury in newborns. Her work also identified the optimal timing of treatment.
Professor Richard Reynolds’s authority on the biology of the nervous system and how white matter is damaged, particularly in multiple sclerosis, is recognised worldwide. Professor Henrik Hagberg is a world expert in brain injury in newborns and recently joined Imperial College to help find ways to combat cerebral palsy.
The researchers’ work has been published in a number of important peer-reviewed journals and is well known in the scientific world. The research will be carried out in the Burlington Danes building on the Hammersmith Hospital campus of Imperial College, which is a new state-of-the-art research facility.
Who stands to benefit from this research and how?
Hopes of preventing brain damage
The researchers are hoping to improve our understanding of what causes brain damage in premature babies. If their suspicions are correct, and the protein called Fas does play a central role in the death of brain cells, then the longer term aim would be to develop treatments that protect premature babies from brain damage by blocking the action of Fas.
It is possible that large numbers of premature babies who are at risk of brain damage could benefit in the future. The findings of this research may also help tackle some other diseases of the nervous system, such as multiple sclerosis.
The ultimate hope is that finding a way to reduce or prevent brain damage following premature birth could save babies’ lives and stop them from developing long-term problems such as cerebral palsy, epilepsy and intellectual impairment. Children who would otherwise have faced a lifetime of complications could be given a normal life.
The potential benefits to babies and their families, of preventing brain damage and serious disabilities, are enormous.
- Volpe JJ (2000) Neurology of the Newborn. Philadelphia. WB Saunders.
- The information centre. NHS Maternity Statistics 2008-9.
- Hospital Episode Statistics (HES) Online. Maternity Data. Gestation. Table 27: Deliveries by length of gestation and method of onset of labour. 2008-9. http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=1054