Hypoxic-Ischemic Encephalopahy (HIE), also known as Perinatal Asphyxia, is brain injury caused by asphyxia. It is caused primarily by systemic hypoxemia (low blood oxygen) and/or reduced cerebral blood flow. Birth asphyxia causes 23%
of all neonatal deaths worldwide.
Current vs. new treatment
Newborns with HIE are traditionally treated with “cooling”, a method that induces hypothermia. However, a substantial percentage (>30%) either do not survive or have significant impairment. In studies performed in neonatal rodents, the post-injury infusion of human umbilical cord blood has been shown to improve neurobehavioral outcome, reduce inflammation, and aid in the formation of new blood vessels.
Cotton, et al recently reported results from a study performed at Duke using an infant’s own umbilical cord blood cells in addition to cooling (J Pediatr. 2013 Dec 31. pii: S0022-3476(13)01471-6. doi: 10.1016/j.jpeds.2013.11.036. [Epub ahead of print]). The authors compared hospital outcomes (mortality, oral feeds at discharge) and 1-year survival with Bayley Scales of Infant and Toddler Development, 3rd edition scores >85 in 3 domains (cognitive, language, and motor development) between cell recipients and cooled infants who did not have available cells. 13 of 18 (74%) cell recipients and 19 of 46 (41%) concurrent cooled infants with known 1-year outcomes survived with scores >85, suggesting a beneficial effect of cord blood.
More to come
Further studies will be conducted, but the initial results are promising and demonstrate that umbilical cord blood infusions are safe for infants affected with HIE. HIE may be one more debilitating condition that can be safely treated through the use of umbilical cord blood cells.