World First: Protecting the brains of BC’s newborns

15 March 2011

The staff in the neonatal intensive care unit (NICU) at BC Women's Hospital is dedicated to ensuring the best possible medical care for babies. As a result, clinical research that's taken place there has led to important discoveries on brain injuries.

MSFHR's Career Investigator Program funding supported Dr. Steven Miller, Canada Research Chair, in neonatal neuroscience, to research neuro-developmental impairments in pre-term infants and infants born with heart defects. His work is set to lead to improvements in preventing or treating brain injury by optimizing care.

"The three highest risk groups of babies we see in BC are those born prematurely, those with congenital heart disease or heart-birth defects, and those who have sustained asphyxia (a lack of brain oxygen/blood flow)," says Miller. The largest of his team's studies focused on pre-term infants and resulted in the discovery that infection after birth can predispose these infants to white matter (nerve tissue) injury.

"While babies are in intensive care, they are at risk for a number of illnesses and infections, and they are usually on mechanical ventilators," explains Miller. These illnesses and infections and associated therapies can impact brain development at a critical time in an infant's development.

"About one third of pre-term babies in our studies acquire white matter injuries during the course of their stay in hospital," says Miller. Their recent finding that infection in the womb would predispose to white matter injury was contrary to evidence from other studies. "We looked at this and found that it didn't pose a significant risk — but infection after birth did, as did low blood pressure."

In a second series of studies, Miller's group compared a group of full-term infants with heart-birth defects that were scanned prior to heart surgery, with scans taken of healthy full-term babies.

"We found that brain development was delayed compared with normal, full-term babies that didn't have heart disease," says Miller. "This suggested that having heart disease would predispose to delayed brain development in the womb and that may be why these babies are also vulnerable to white matter injury."

Miller's team achieved another first in Canada with the implementation of a specialized MRI-compatible incubator that allows very sick babies to be moved safely, with life support equipment, from the intensive care unit to the MRI scanner and to be scanned without sedation. "That's another first in neonatal neurology research in Canada," he says, crediting the parents and his team at BC Children's Hospital and the Child & Family Research Institute for helping make these important discoveries possible.

He also credits MSFHR funding. "All these factors helped get the program established and moving forward," he says.

Miller's research on brain development in newborns is one of many noteworthy achievements of MSFHR Career Investigators identified in a new report that analyses MSFHR's Career Investigator Program and its contribution to building BC's health research capacity. Read the report (PDF)