Infection-related perinatal brain injury: the pathogenic role of impaired fetal cardiovascular control.
There is a growing body of evidence from clinical and epidemiologic studies that in utero exposure to infection plays an important role in the genesis of fetal or neonatal injury leading to cerebral palsy and chronic lung disease. Thus, after chorioamnionitis the incidence of immature neonates with periventricular white matter damage and periventricular or intraventricular hemorrhage is significantly elevated. Recent clinical and experimental data support the hypothesis that a fetal inflammatory response links antenatal infection with brain white matter damage and subsequent motor handicap. A variety of studies support the view that cytokines released during intrauterine infection directly cause injury to the immature brain. In this review, we provide evidence that in utero exposure to bacterial infection can severely alter fetal cardiovascular function, resulting in dysregulation of cerebral blood flow and subsequent hypoxic-ischemic brain injury.
Garnier
Yves
Y
Department of Obstetrics and Gynecology, University of Bochum, In der Schornau 23-25, 44982 Bochum, Germany.
Coumans
Audrey B C
AB
Jensen
Arne
A
Hasaart
Tom H M
TH
Berger
Richard
R
D000818:Animals; D002319:Cardiovascular System / Q000196:embryology / Q000503:physiopathology*; D002543:Cerebral Hemorrhage / Q000196:embryology / Q000209:etiology; D002547:Cerebral Palsy / Q000209:etiology; D016207:Cytokines / Q000378:metabolism; D019332:Endothelin-1 / Q000502:physiology; D019446:Endotoxemia / Q000196:embryology / Q000473:pathology; D004731:Endotoxins / Q000378:metabolism / Q000633:toxicity; D005260:Female; D005315:Fetal Diseases / Q000209:etiology*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology*; D009569:Nitric Oxide / Q000378:metabolism; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000209:etiology* / Q000473:pathology
D016207:Cytokines; D019332:Endothelin-1; D004731:Endotoxins; D009569:Nitric Oxide