Understanding brain blood flow to reduce brain damage in babies

The understanding of brain damage in preterm newborn babies has taken a big step, with a world-first study identifying significant differences in the mechanics of blood supply to the preterm brain.

Associate Professor Flora Wong, together with Dr Ishmael Inocencio and Ms Nhi Tran, outlining their discovery on brain damage in babies.
L–R: Nhi Tran, Associate Professor Flora Wong, Dr Ishmael Inocencio

Preterm birth is a global problem and contributes to around 7 per cent of all Australian births. It is also a significant risk factor for neurodevelopmental disabilities and cerebral palsy.

An international research team led by Associate Professor Flora Wong discovered that following increased brain activity, blood vessels in the immature preterm brain respond differently compared to those in the term brain.

A/Prof Wong, a Research Group Head at Hudson Institute and Monash University, and consultant neonatologist at Monash Children’s Hospital, was working alongside Hudson’s Dr Ishmael Inocencio and Ms Nhi Tran.

Dr Inocencio says this research has serious implications for how life-changing treatments can be delivered.

Oxygen delivery in the immature brain

“Using state-of-the-art imaging techniques at the Australian Synchrotron, we compared the function of very small blood vessels within full term and preterm brains to understand why oxygen delivery in the immature brain does not always match the oxygen demand.”

“We found that blood vessels within the brain respond differently to an increase in brain activity, and subsequently an increase in oxygen demand, depending on the brain’s level of maturity.”

“This is an important finding for clinicians working to help prevent brain injury caused by brain oxygen deprivation in newborn babies,” Dr Inocencio said.

Essentially, the research showed that when oxygen demand increases, the mature brain opens up more blood vessels to enable increased blood supply, but the same response does not occur in the immature brain.

Ms Tran said: “These results suggest that, when faced with stronger brain stimulations, the blood vessels within the preterm brain may be unable to deliver adequate blood flow and oxygen – this may then lead to brain injury.”

Brain injury in preterm babies

According to A/Prof Wong, this study is the first to show how immature blood vessel function may underlie brain injury in preterm babies.

Hudson Institute researchers are internationally known for their work in resuscitating infants who do not get enough oxygen at birth and protecting and treating the brains of these babies who are at high risk of developing conditions such as cerebral palsy.

They are investigating the newborns transition to birth, associated breathing difficulties and the potential benefits of delaying umbilical cord clamping, which may help prevent oxygen deprivation in newborns. They are also focusing on improving treatments for infants who have suffered severe birth asphyxia.

Funders | The Victorian Government’s Operational Infrastructure Support Program, Japan Society for the Promotion of Science, National Health and Medical Research Council (NHMRC), National Heart Foundation.

Collaborators | Monash University, Melbourne, Australia; RMIT University, Melbourne, Australia; Kagawa University, Kagawa, Japan; Australian Synchrotron, ANSTO, Melbourne, Australia; National Cerebral and Cardiovascular Centre, Osaka, Japan.

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