Document Detail


"Miracle" extremely low birth weight neonates: examples of developmental plasticity.
MedLine Citation:
PMID:  20966704     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Many extremely low birth weight (LBW) neonates now survive with intensive care. Their survival depends on fetal and neonatal adaptations of multiple organ systems, which represents a plasticity of development. Many extremely LBW neonates do not have severe lung immaturity, will breathe, and do not require surfactant treatment. The two clinically relevant modulators of this early lung maturation are antenatal corticosteroid treatments and fetal exposure to inflammation. Those same frequent fetal exposures also can mature the fetal innate immune system to become more proinflammatory. However, repeated fetal exposures to inflammatory mediators can blunt fetal inflammatory responses, which may minimize fetal injury. The brain of the extremely LBW neonate grows differently from that of the normal fetus such that brain volumes are different at term for the extremely LBW neonate and the term neonate. Regions of brain used to process information also differ from the child who was born very preterm and the child born at term. The adaptations that permit survival after very preterm birth may have adverse effects in later life. The biology of multiple organ system plasticities resulting from very preterm birth remains to be extensively explored.
Authors:
Alan H Jobe
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  116     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-22     Completed Date:  2010-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1184-90     Citation Subset:  AIM; IM    
Affiliation:
Cincinnati Children's Hospital, Division of Pulmonary Biology, University of Cincinnati, Cincinnati, Ohio 45229-3039, USA. alan.jobe@cchmc.org
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological
Anti-Inflammatory Agents / administration & dosage
Brain / growth & development,  physiology
Child
Child Development*
Chorioamnionitis / physiopathology
Cognition
Female
Fetal Organ Maturity*
Fetus / immunology
Glucocorticoids / administration & dosage
Humans
Infant, Extremely Low Birth Weight / physiology*
Infant, Newborn
Inflammation
Lung / embryology,  growth & development*
Male
Pregnancy
Respiratory Distress Syndrome, Newborn / physiopathology
Grant Support
ID/Acronym/Agency:
HD57869/HD/NICHD NIH HHS; HL97064/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Glucocorticoids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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