May 26, 2024

Blood test breakthrough reveals cause of brain injury in newborns

Researchers from Imperial College London have discovered that a blood test has the potential to uncover the underlying cause of brain injury in newborn babies. The study focused on infants with hypoxia-related brain injuries, which occur when there is a lack of oxygen. It revealed that patterns of gene expression in the blood could indicate the cause of the injury and help doctors determine if the newborn is likely to respond to cooling treatment, a common method used to treat brain injuries in infants.

The findings, recently published in the journal JAMA Network Open, could eventually pave the way for a simple and efficient test to quickly diagnose brain injuries in newborns, facilitating more effective treatment decisions.

The research included babies from both low and middle-income countries (LMICs) and high-income countries (HICs). Surprisingly, there was a stark difference in gene expression between the two groups, indicating that the underlying cause of brain injuries varies between them.

Professor Sudhin Thayyil, the lead investigator from the Department of Brain Sciences at Imperial College London, commented on the study’s significance, saying, “Although cases of brain injury in babies may appear similar, they can be quite different in terms of how they come about, as our study shows. The gene expression patterns we saw in babies from LMICs were similar to what you would see in people with sleep apnea, suggesting that they experienced intermittent hypoxia in the womb and at birth.”

He further explained that this outcome likely results from multiple chronic stresses during pregnancy, including poor nutrition or infection, as well as the normal labor process and uterine contractions. Such factors lead to further hypoxia, ultimately causing injury to the baby’s brain.

Conversely, the gene expression patterns in babies from HICs suggested a single, acute cause of brain injury, such as complications during birth, like maternal bleeding, resulting in a sudden drop in blood oxygen levels in the fetus. Hypoxic-ischemic encephalopathy (HIE), also known as birth asphyxia, is a form of brain injury that occurs when a baby’s brain does not receive enough oxygen before or shortly after birth.

Globally, HIE is a primary cause of death and disability among full-term newborns, affecting around 3 million babies each year. Following oxygen deprivation, brain injuries can develop over hours to months, affecting different regions of the brain and leading to various potential neurodisabilities, including cerebral palsy, epilepsy, deafness, or blindness.

Notably, South Asia, particularly India, carries the highest burden of this disease, with the country accounting for 60% of all HIE-related deaths worldwide.

Existing studies conducted in high-income countries (HICs) have demonstrated that whole-body cooling treatment can improve outcomes for babies with HIE. Consequently, it has become standard practice in many HICs and is also implemented in some hospitals in South Asia.

However, Professor Thayyil’s team previously conducted the largest study of its kind in low- and middle-income countries (LMICs), which revealed that whole-body cooling treatment actually worsened outcomes for babies with HIE and potentially increased the risk of mortality.

This recent study sheds light on the disparity in treatment response between the two groups of infants, offering insight into establishing a simple test to evaluate which babies are most likely to benefit from cooling treatment. The development of such a test could greatly improve treatment outcomes for newborns suffering from brain injuries.

1. Source: Coherent Market Insights, Public sources, Desk research
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