Intrauterine Infektion und das Gehirn Frühgeborener - Dimensionen der Ätiologieforschung

Zusammenfassung

Die Ätiologie perinataler Hirnschäden ist vielfältig und komplex. In den vergangenen Jahrzehnten sind in diesem Forschungsbereich zahlreiche neue Erkenntnisse erarbeitet worden. In diesem Artikel diskutiere ich sieben Dimensionen der Ätiologieforschung: (1) Hypoxie-Ischämie vs Inflammation; (2) „klassische” vs „remote” intrauterine Infektion; (3) fokale vs diffuse Schäden in der weißen Substanz; (4) maternale vs fetale Inflammationsreaktion; (5) klinische vs experimentelle Daten; (6) bakterielle vs virale Infektion; und (7) Früh- vs Termingeburt. Aus perinatal neuroepidemiologischer Perspektive bleibt trotz der offensichtlich komplexen Forschungslage zu hoffen, dass es zeitnah zu einem regen Austausch zwischen Geburtshelfern, Neonatologen und Neuropädiatern und der gemeinsamen Planung einer perinatal neuroprotektiven Strategie kommen möge.

Abstract

Perinatal brain damage has a diverse and complex aetiology. Over the past decades, much progress has been made in this research field. In this article, I offer a discussion of seven dimensions of aetiological perinatal brain damage research: (1) hypoxia-ischaemia vs. inflammation; (2) „classic” vs. „remote” intrauterine infection; (3) focal vs. diffuse white matter damage; (4) maternal vs. foetal inflammatory response; (5) clinical vs. experimental data; (6) bacterial vs. viral infection; and (7) preterm vs. term delivery. Despite these complexities, it is hoped that obstetricians, neonatologists, and neuropaediatricians will agree on a perinatal neuroprotective strategy in the near future.

Schlüsselwörter

Frühgeburt - Infektion - Gehirn - Ätiologie

Key words

Prematurity - Infection - Brain - Etiology

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