Pathophysiology of perinatal asphyxia: can we predict and improve individual outcomes?

Morales, Paola; Bustamante, Diego; Espina-Marchant, Pablo; Neira-Peña, Tania; Gutiérrez-Hernández, Manuel; Allende-Castro, Camilo; Rojas-Mancilla, Edgardo

Keywords: sequelae, Neonatal, Hypoxia-ischemia, Predictive diagnostic, Personalised treatments

Abstract

Perinatal asphyxia occurs still with great incidence whenever delivery is prolonged, despite improvements in perinatal care. After asphyxia, infants can suffer from short- to long-term neurological sequelae, their severity depend upon the extent of the insult, the metabolic imbalance during the re-oxygenation period and the developmental state of the affected regions. Significant progresses in understanding of perinatal asphyxia pathophysiology have achieved. However, predictive diagnostics and personalised therapeutic interventions are still under initial development. Now the emphasis is on early non-invasive diagnosis approach, as well as, in identifying new therapeutic targets to improve individual outcomes. In this review we discuss (i) specific biomarkers for early prediction of perinatal asphyxia outcome; (ii) short and long term sequelae; (iii) neurocircuitries involved; (iv) molecular pathways; (v) neuroinflammation systems; (vi) endogenous brain rescue systems, including activation of sentinel proteins and neurogenesis; and (vii) therapeutic targets for preventing or mitigating the effects produced by asphyxia.

Más información

Título de la Revista: EPMA J
Volumen: 2
Número: 2
Editorial: Springer International Publishing
Fecha de publicación: 2011
Página de inicio: 211
Página final: 230
Idioma: English
Financiamiento/Sponsor: BioMed Central
DOI:

doi: 10.1007/s13167-011-0100-3.