Grant: Project Grant

In a baby, when there is a problem with oxygen or blood flow to the brain around the time of birth, we call this neonatal hypoxic-ischemic encephalopathy (HIE). Almost half of babies with HIE go on to have concerns with their development, such as cerebral palsy. We need to find better ways to identify babies needing early supports for their development and better ways to care for them in the Neonatal Intensive Care Unit (NICU) to promote brain development. In this study, we have three main goals. First, we want to identify, as early as possible, which babies will have neurodevelopmental problems. Predicting development using MRI pictures of the brain when they are newborns is effective only when HIE is severe but challenging for most where HIE is less severe. In these babies, it may be helpful to look at brain networks, which are important for key functions (such as walking or talking) that children develop over time. Understanding how HIE affects brain networks might help us identify earlier which babies have a high risk for concerns with their development. Second, we will look more closely at how pain influences brain connections so that we can improve how we care for babies with HIE in the NICU to promote brain development. Babies with HIE experience many painful procedures as part of lifesaving care but early exposure to pain may have lasting effects. The medications we use to treat pain may also have effects on the brain, making it challenging to know the best approach to treat pain in babies while promoting brain development. Third, we will look at whether HIE affects boys and girls differently. In animal studies, males appear to have worse effects of HIE, with more severe brain injury. Human studies of neonatal HIE have not looked at this difference between male and female babies. We also don't know if there are sex differences in brain network development in HIE. Through this study, we hope to find new ways to support development in babies with HIE.