Hypoxic ischemic encephalopathy (HIE) occurs when a fetus or baby does not get enough oxygen to the brain, leading to damage and potentially to conditions like cerebral palsy. It can happen during pregnancy, labor, or delivery.
HIE can cause mild to severe disabilities, depending on how long or how significantly the brain was deprived of oxygen. Immediate treatment for HIE is essential for minimizing damage, but until now just one treatment has been available. Researchers show promise for two additional interventions.
Therapeutic Hypothermia
A baby may experience HIE during labor or delivery if there are complications. For instance, if the umbilical cord becomes wrapped around the neck or the placenta detaches from the uterus, these can cut off oxygen to the brain. To protect the baby from future disabilities, it is essential to diagnose and treat HIE as soon as possible after delivery.
Currently, the standard treatment for HIE is to cool the baby’s brain followed by slow and careful re-warming. If the brain can be cooled to about 91.4 degrees Fahrenheit (33 degrees Celsius) for 72 hours, some of the damage can be avoided. This is not necessarily a cure, but it can minimize disabilities if administered within a few hours.
Treatment with Cannabidiol
Hypothermic treatment can be useful for a newborn with HIE, but it requires almost immediate application. And it doesn’t work in every situation. Researchers are developing new, better treatments with some promising results.
One of these is treatment with cannabidiol, or CBD, a non-psychoactive compound in cannabis. CBD has been shown in many studies to have protective effects on the brain in a variety of situations and for several conditions, like Parkinson’s disease. It reduces inflammation, slows damage caused by oxidative stress, and reduces other factors that may cause permanent brain damage.
The use of any cannabis product in infants has been controversial, but clinical trials have finally been approved after studies with pigs showed effectiveness when used with hypothermia. In these animal studies researchers reduced brain damage by nearly 100%. Another promising aspect of adding CBD to treatment is that the window for its effectiveness is up to 24 hours.
Peptide Inhibitors
Inflammation in the brain triggered by HIE may be the main cause of brain damage and resulting disabilities. This is why cooling and CBD may help reverse or limit damage. Another new research avenue for treatment is the use of a peptide inhibitor called C1P1.
Researchers hope C1P1 will act like a roadblock for a major inflammatory pathway in the brain triggered by oxygen deprivation. Again, animal studies have been promising. These laboratory studies show that the inhibitor can reduce inflammation and minimize brain damage.
HIE does not always cause cerebral palsy and other disabilities, but it often does. The cooling therapy that is currently accepted for treatment helps but is limited. If the doctor does not recognize or diagnose the signs of HIE right away, it’s too late to use the therapy. These new treatments, with or without hypothermic treatment, may provide the key to minimizing cerebral palsy risk during difficult and complicated pregnancies that lead to HIE.
