Review Article Infection-Related Perinatal Brain Injury: The Pathogenic Role of Impaired Fetal Cardiovascular Control

There is a growing body ofevidencefrom clinical and epidemiologic studies that in utero exposure to infection plays an important role in the genesis offetal or neonatal injury leading to cerebral palsy and chronic lung disease. Thus, after chorioamnionitis the incidence of immature neonates with periventricular white matter damage and periventricular or intraventricular hemorrhage is significantly elevated. Recent clinical and experimental data support the hypothesis that afetal inflammatory response links antenatal infection with brain white matter damage and subsequent motor handicap. A variety of studies support the view that cytokines released during intrauterine infection directly cause injury to the immature brain. In this review, we provide evidence that in utero exposure to bacterial infection can severely alterfetal cardiovascularfunction, resulting in dysregulation of cerebral bloodflow and subsequent hypoxic-ischemic brain injury. (J Soc Gynecol Investig 2003; 10:450-9) Copyright C) 2003 by the Society for Gynecologic Investigation. espite improvements in perinatal medicine, the prev-alence of cerebral palsy has increased over the last 2 decades,1 and the etiology of cerebral palsy remains poorly understood. As demonstrated by a variety of recent clinical and epidemiologic studies, inflammatory reactions no