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Brain Damage Seen in Some Newborn Deaths

Scottish Study Shows Damage Often Precedes Labor
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Aug. 19, 2004 - Many babies who die during or shortly after birth may have had brain damage that makes them susceptible to death, according to a new Scottish study.

Being born prematurely or with major malformations are the leading causes of newborn deaths. But some babies appear to have faulty development of the brain or a disability that disrupts the brain's ability to control breathing.

Many of these infants die despite a normal pregnancy and delivery. According to the authors, autopsy reports have suggested that these early infant deaths are linked to brain damage that occurs prior to labor.

There was nothing any doctor or parent could have done to predict the brain damage before delivery, reports the study, published in the journal Archives of Disease in Childhood.

Led by child life and health professor Neil McIntosh of the University of Edinburgh, researchers gathered data on 137 babies who died soon after birth in Scotland over a two-year period.

Many of the newborn deaths happened within hours of delivery.

Autopsies Show Brain Damage

With parental permission, brain samples were taken from 70 of the autopsied infants for extensive examination.

Fifty-three newborns were classified as having decreased control of breathing while alive. The other infant deaths were not classified as such.

Both full-term and premature infants classified as having difficulty breathing were more likely to show signs of brain damage upon autopsy compared with infants that were not classified as having difficulty breathing. However, brain damage was not present in every infant who showed signs of difficulty breathing, write the researchers.

The authors say that 57% of those that had difficulty breathing had evidence suggesting brain damage prior to birth compared with only 8% of the other infants.

The brain injuries were probably sustained "only shortly before the onset of labour (even possibly precipitating the onset of labour)," write the researchers.

The researchers didn't see any warning signs that could have helped prepare parents and doctors, but they were able to clear up some misunderstandings about the newborn deaths.

Birth asphyxiation is not necessarily the result of a mismanaged labor or the lack of vigilance in pregnancy, the researchers conclude.

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