Jump to ContentJump to Main Navigation
Show Summary Details

Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

9 Issues per year

IMPACT FACTOR increased in 2015: 1.798
Rank 46 out of 120 in category Pediatrics in the 2015 Thomson Reuters Journal Citation Report/Science Edition

SCImago Journal Rank (SJR) 2014: 0.731
Source Normalized Impact per Paper (SNIP) 2014: 0.687
Impact per Publication (IPP) 2014: 1.483

See all formats and pricing
Volume 28, Issue 4 (Aug 2000)


Perinatal brain injury

Richard Berger / Yves Garnier
Published Online: 2005-06-01 | DOI: https://doi.org/10.1515/JPM.2000.034


Perinatal brain damage in the mature fetus is usually brought about by severe intrauterine asphyxia following an acute reduction of the uterine or umbilical circulation. The areas most heavily affected are the parasagittal region of the cerebral cortex and the basal ganglia. The fetus reacts to a severe lack of oxygen with activation of the sympathetic-adrenergic nervous system and a redistribution of cardiac output in favor of the central organs (brain, heart and adrenals). If the asphyxic insult persists, the fetus is unable to maintain circulatory centralization, and the cardiac output and extent of cerebral perfusion fall. Owing to the acute reduction in oxygen supply, oxidative phosphorylation in the brain comes to a standstill. The Na+/K+ pump at the cell membrane has no more energy to maintain the ionic gradients. In the absence of a membrane potential, large amounts of calcium ions flow through the voltage-dependent ion channels, down an extreme extra-/intracellular concentration gradient, into the cell. Current research suggests that the excessive increase in levels of intracellular calcium, so-called calcium overload, leads to cell damage through the activation of proteases, lipases and endonucleases. During ischemia, besides the influx of calcium ions into the cells via voltage-dependent calcium channels, more calcium enters the cells through glutamate-regulated ion channels. Glutamate, an excitatory neurotransmitter, is released from presynaptic vesicles during ischemia following anoxic cell depolarization. The acute lack of cellular energy arising during ischemia induces almost complete inhibition of cerebral protein biosynthesis. Once the ischemic period is over, protein biosynthesis returns to preischemic levels in non-vulnerable regions of the brain, while in more vulnerable areas it remains inhibited. The inhibition of protein synthesis, therefore, appears to be an early indicator of subsequent neuronal cell death. A second wave of neuronal cell damage occurs during the reperfusion phase. This cell damage is thought to be caused by the postischemic release of oxygen radicals, synthesis of nitric oxide (NO), inflammatory reactions and an imbalance between the excitatory and inhibitory neurotransmitter systems. Part of the secondary neuronal cell damage may be caused by induction of a kind of cellular suicide programme known as apoptosis. Interestingly, there is increasing evidence from recent clinical studies that perinatal brain damage is closely associated with ascending intrauterine infection before or during birth. However, a major part of this damage is likely to be of hypoxic-ischemic nature due to LPS-induced effects on fetal cerebral circulation. Knowledge of these pathophysiological mechanisms has enabled scientists to develop new therapeutic strategies with successful results in animal experiments. The potential of such therapies is discussed here, particularly the promising effects of intravenous administration of magnesium or postischemic induction of cerebral hypothermia.

About the article

Published Online: 2005-06-01

Published in Print: 2000-08-11

Citation Information: Journal of Perinatal Medicine, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2000.034. Export Citation

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Linlin Xu, Wenhong Dong, Jie Zhao, and Yajun Xu
Marine Drugs, 2015, Volume 13, Number 6, Page 3653
Victor Camera Pimentel, Maria Beatriz Moretto, Mariana Colino Oliveira, Daniela Zanini, Ana Maria Sebastião, and Maria Rosa Chitolina Schetinger
Molecular and Cellular Biochemistry, 2015, Volume 403, Number 1-2, Page 169
T. Neira-Peña, E. Rojas-Mancilla, V. Munoz-Vio, R. Perez, M. Gutierrez-Hernandez, D. Bustamante, P. Morales, M. A. Hermoso, P. Gebicke-Haerter, and M. Herrera-Marschitz
Neurotoxicity Research, 2015, Volume 27, Number 4, Page 453
David Dinan, Alan Daneman, Carolina V. Guimaraes, Nancy A. Chauvin, Teresa Victoria, and Monica Epelman
Seminars in Ultrasound, CT and MRI, 2014, Volume 35, Number 6, Page 627
M Mutinati, M Pantaleo, M Roncetti, M Piccinno, A Rizzo, and RL Sciorsci
Reproduction in Domestic Animals, 2014, Volume 49, Number 1, Page 7
Joji Inamasu and Kiyoshi Ichikizaki
Annals of Emergency Medicine, 2002, Volume 40, Number 2, Page 220
Salvatore Aversa, Salvatore Pellegrino, Ignazio Barberi, Russel J. Reiter, and Eloisa Gitto
Journal of Maternal-Fetal and Neonatal Medicine, 2012, Volume 25, Number 3, Page 207
Katja Rosenkranz, Sandra Kumbruch, Matthias Tenbusch, Katrin Marcus, Katrin Marschner, Rolf Dermietzel, and Carola Meier
Cell and Tissue Research, 2012, Volume 348, Number 3, Page 429
Seth Love
Current Diagnostic Pathology, 2004, Volume 10, Number 2, Page 106
Michael D. Weiss, Shag Derazi, Candace Rossignol, Helene Varoqui, Jeffrey D. Erickson, Michael S. Kilberg, and Kevin J. Anderson
Developmental Brain Research, 2003, Volume 143, Number 2, Page 151
I. K. Tomilova, O. A. Gromova, and O. V. Grishina
Neurochemical Journal, 2012, Volume 6, Number 1, Page 1
John H. Zhang, Takkin Lo, George Mychaskiw, and Austin Colohan
Pathophysiology, 2005, Volume 12, Number 1, Page 63
Isaac Blickstein
Clinics in Perinatology, 2004, Volume 31, Number 3, Page 395
Monica Epelman, Alan Daneman, Nancy Chauvin, and Wolfgang Hirsch
Magnetic Resonance Imaging Clinics of North America, 2012, Volume 20, Number 1, Page 93
Candice L. Rodricks, Marie E. Gibbs, Margie Castillo-Melendez, and Suzanne L. Miller
International Journal of Developmental Neuroscience, 2010, Volume 28, Number 4, Page 343
Alan R. Spitzer and Donald Chace
Clinics in Perinatology, 2008, Volume 35, Number 4, Page 695
David Fernández-López, José Martínez-Orgado, Ignacio Casanova, Bartolomé Bonet, Juan Carlos Leza, Pedro Lorenzo, Maria Ángeles Moro, and Ignacio Lizasoain
Journal of Neuroscience Methods, 2005, Volume 145, Number 1-2, Page 205
John W Calvert, Wei Yin, Mona Patel, Ahmed Badr, George Mychaskiw, Andrew D Parent, and John H Zhang
Brain Research, 2002, Volume 951, Number 1, Page 1
Laura Lenti, Ferenc Domoki, David Kis, Orsolya Hegyi, Gabor K. Toth, David W. Busija, and Ferenc Bari
Brain Research, 2007, Volume 1165, Page 81
Flavio Villani, Ludovico D’Incerti, Tiziana Granata, Giorgio Battaglia, Paolo Vitali, Luisa Chiapparini, and Giuliano Avanzini
Epilepsy Research, 2003, Volume 55, Number 3, Page 235
Katja Rosenkranz and Carola Meier
Annals of Anatomy - Anatomischer Anzeiger, 2011, Volume 193, Number 4, Page 371
Jie Fu, Shi-Dou Zhao, Hui-Juan Liu, Qiu-Huan Yuan, Shang-Ming Liu, Yan-Min Zhang, Eng-Ang Ling, and Ai-Jun Hao
Journal of Pineal Research, 2011, Volume 51, Number 1, Page 104
Daniel Alonso-Alconada, Antonia Alvarez, and Enrique Hilario
Neuroscience Bulletin, 2011, Volume 27, Number 4, Page 275
Paola Morales, Diego Bustamante, Pablo Espina-Marchant, Tanya Neira-Peña, Manuel A. Gutiérrez-Hernández, Camilo Allende-Castro, and Edgardo Rojas-Mancilla
The EPMA Journal, 2011, Volume 2, Number 2, Page 211
Stephen Ashwal and William J. Pearce
Current Opinion in Pediatrics, 2001, Volume 13, Number 6, Page 506
Journal of Perinatal Medicine, 2001, Volume 29, Number 1
Mario Herrera-Marschitz, Paola Morales, Lisette Leyton, Diego Bustamante, Verena Klawitter, Pablo Espina-Marchant, Camilo Allende, Francisco Lisboa, Gabriel Cunich, Antonella Jara-Cavieres, Tanya Neira, Manuel A. Gutierrez-Hernandez, Victor Gonzalez-Lira, Nicola Simola, Andrea Schmitt, Micaela Morelli, R. Andrew Tasker, and Peter J. Gebicke-Haerter
Neurotoxicity Research, 2011, Volume 19, Number 4, Page 603
Annals of the New York Academy of Sciences, 2008, Volume 1053, Number 1, Page 84
Xing Wei, Zhimei Du, Liming Zhao, Dongni Feng, Gang Wei, Yongzheng He, Jiangning Tan, Wei-Hui Lee, Harald Hampel, Richard Dodel, Brian H. Johnstone, Keith L. March, Martin R. Farlow, and Yansheng Du
Stem Cells, 2009, Volume 27, Number 2, Page 478
Jin Zhong, Limin Zhao, Yansheng Du, Gang Wei, Wei-Guo Yao, and Wei-Hua Lee
Neurological Research, 2009, Volume 31, Number 5, Page 483
John W. Calvert and John H. Zhang
Neurological Research, 2005, Volume 27, Number 3, Page 246
Eloisa Gitto, Salvatore Pellegrino, Placido Gitto, Ignazio Barberi, and Russel J. Reiter
Journal of Pineal Research, 2009, Volume 46, Number 2, Page 128
H. Figueroa-Diesel, E. Hernandez-Andrade, R. Acosta-Rojas, L. Cabero, and E. Gratacos
Ultrasound in Obstetrics and Gynecology, 2007, Volume 30, Number 3, Page 297
Diego Bustamante, Paola Morales, Jorge Torres Pereyra, Michel Goiny, and Mario Herrera-Marschitz
Experimental Brain Research, 2007, Volume 177, Number 3, Page 358
Uwe Ebmeyer and Laurence M. Katz
Current Opinion in Critical Care, 2001, Volume 7, Number 3, Page 189
Hande Gulcan, I.Cetin Ozturk, and Selda Arslan
Biology of the Neonate, 2005, Volume 88, Number 2, Page 87
Osuke Iwata, Sachiko Iwata, Masanori Tamura, Tomohiko Nakamura, Masatoshi Sugiura, Yoshifumi Ogiso, and Sachio Takashima
Pediatrics International, 2003, Volume 45, Number 5, Page 522
K. Rentmeister, S. Schmidbauer, M. Hewicker-Trautwein, and A. Tipold
Journal of Veterinary Medicine Series A, 2004, Volume 51, Number 7-8, Page 327

Comments (0)

Please log in or register to comment.
Log in