Injury in newborn infants. Basic mechanisms related to oxidative stress and bilirubin encephalopathy

In this project we plan to continue our long term studies regarding basic mechanisms of brain injury in newborn infants. We have previously shown that oxidative stress both in preterm and term infants induces long term potential harmful effects that may affect growth and development. As the first we have shown that a brief exposure of oxygen at birth may increase neonatal mortality and increase the time to first cry and breath. Further, heart rate at 90 sec and Apgar score at 5 min are significantly l ower in newborns exposed to pure oxygen at birth. These data that recently have been summarized in a Cocrhane review and a meta-analysis and an editorial in The Lancet indicate that ten thousands of newborn infants worldwide may be rescued each year by avoiding the use of pure oxygen for newborn resuscitation. Thus this finding may represent one of the most successful breakthroughs in neonatal medicine as well as in Norwegian medical research. We also have gained new insight into basic mechanisms of b ilirubin toxicity on the human brain. By using human neuron cells in culture, animal models as well as participating in international randomized clinical trials we will contribute to new knowledge and probably in the development of new therapeutic guid elines for newborn infants. Through an extensive national and international collaboration we have access to the most sophisticated methods to assess cell affection and injury even at the molecular level.