Professor of Pediatrics and Neurology
University of California, San Franscisco, USA
THEME: THE NEWBORN WITH A VULNERABLE BRAIN: A 21ST CENTURY VIEW OF
NEUROPROTECTION & REPAIR
The first six hours of life are crucial. It is important to assess the blood parameters, check oxygen level of the baby and
in general, observe how the baby responds to external stimuli. Neonatal brain injury is an important cause of death and
disability, with pathways of oxidant stress, inflammation, and excitotoxicity that lead to damage, which progresses over
a long period of time. There are factors that compromise the developing brain and affect maternal health around
conception and through the period of pregnancy such as trauma through injury, drugs, both prescription and
non-prescription, alcohol, smoking, infections, exposure to toxins and maternal malnutrition, all of which commonly
undermine the desired state of "optimality". Other factors that compromise optimality include peri-natal trauma and
infection through poorly planned or executed delivery of the child and neonatal phase compromises asphyxiation,
jaundice, and early trauma through accidents or abuse, infections, malnutrition.
Care must include better monitoring of the newborn brain with amplitude integrated and continuous EEG, prevention
of neuroinfection and family centered care. This kind of focussed, collaborative clinical effort between neonatologists
and neurologists, combined with training in neonatal neurology for nurses, can do wonders in avoiding further injury and
improve long term neurodevelopmental outcomes.