Hypoxia or lack of oxygen to the brain at birth affects almost 200 babies in Ireland each year and results in death or disability in over two million infants each year globally.
Even a very mild lack of oxygen at birth can have serious long-term effects with significant costs for the affected children, and their families.
A new study carried out at University College Cork and led by Consultant Paediatrician and Principal Investigator at INFANT, Professor Deirdre Murray could improve how doctors diagnose the condition.
The findings relate to a process for the early detection of birth-related brain injury, which could speed up our ability to identify those infants who will benefit the most from cooling.
This therapy must be applied within six hours from the injury to ensure the impact and severity of damage to the brain can be reduced.
The study just recently published in the highly-regarded Journal of the American Medical Association (JAMA) of Neurology is getting a lot of attention in medical circles here at home and abroad.
Professor Murray will present these new findings to neonatologists, neurologists and their teams at an international Brain Monitoring and Neuro-Protection Conference in Florida this month.
“It is the fruition of ten years of work at INFANT. We worked with over 600 newborn babies in Ireland and Sweden, 170 of which were analysed for the latest publication.
"Researchers at Cork’s Infant Centre recorded changes to circulating genetic material in the umbilical cord blood that occur when a newborn is deprived of oxygen.
"We identified two biochemical signals that showed the ability to detect such injuries.
“MicroRNAS are small strands of genetic code that can control the gene expression and protein production of the cell. The microRNAS are found throughout the body and INFANT researchers found them to be abundant in umbilical cord blood and significantly decreased in newborns with HIE.”
Professor Murray said the results could help to provide the first clue that significant injury has occurred and help doctors decide which infants to transfer to a cooling centre for treatment.
“The fact that two different cohorts were used and across two countries and to get the same patterns is very significant.
"The next task will be automating this analysis so that it can be done rapidly at the outside. We are still researching these microRNAs to understand if they have an important role in the cascade of injury which occurs in HIE.
"They are tiny nuclear codes which act like passwords to control the production of proteins in the cell.”
Prof Murray said this research has been previously presented to the European Society for Paediatric Research scientific conference in Paris last October.
“We are pleased our study featured in the American Medical Association (JAMA) as this is a really great validation of our work at INFANT and at Cork University Maternity Hospital”.
Prof Murray thanked the Health Research Board and the National Children’s Research Centre for providing funding and for supporting the work which is being carried out the Infant Centre, which is dedicated to foetal and neonatal research and based at University College Cork and Cork University Maternity Hospital.
The next big project for the team is to submit research in a piglet model showing the difference between babies with HIE with and without serious infection; this work is being done with a team of academics in University College London and will be presented to the Paediatric Academic Societies Meeting in Baltimore, Washington in April.
Neonatal hypoxic-ischemic encephalopathy (HIE) remains a significant cause of neurologic disability all over the world.
Prof Murray said: “Identifying infants suitable for therapeutic hypothermia (brain cooling) within a narrow therapeutic time is difficult and up to now, there has been no single robust biochemical marker available to clinicians.”
This new research has been able to identify the microRNA in the umbilical cord and this as Professor Murray says is a very important step in the early diagnosis and treatment of babies affected by lack of oxygen to the brain.
“We are delighted as we have been publishing in this area for a long time. We are very grateful for the funding support from the NCRC and HRB and we will be focussed on developing this work further as an effective point-of-care test.”