Christopher A. Lear
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View article: Delayed necrostatin-1s infusion attenuates cystic white matter injury in preterm fetal sheep
Delayed necrostatin-1s infusion attenuates cystic white matter injury in preterm fetal sheep Open
Severe, cystic white matter injury (WMI) in preterm infants is associated with neurodevelopmental impairment. Strikingly, it often develops weeks after birth. In the present study we tested the hypothesis that necrotic programmed cell deat…
View article: Preventive, rescue and reparative neuroprotective strategies for the fetus and neonate
Preventive, rescue and reparative neuroprotective strategies for the fetus and neonate Open
Neonatal encephalopathy remains a major contributor to death and disability around the world. Acute hypoxia-ischaemia before, during or after birth creates a series of events that can lead to neonatal brain injury. Understanding the evolut…
View article: The peripheral chemoreflex and fetal defenses against intrapartum hypoxic-ischemic brain injury at term gestation
The peripheral chemoreflex and fetal defenses against intrapartum hypoxic-ischemic brain injury at term gestation Open
Fetal hypoxemia is ubiquitous during labor and, when severe, is associated with perinatal death and long-term neurodevelopmental disability. Adverse outcomes are highly associated with barriers to care, such that developing countries have …
View article: Monitoring chaos at the cot-side
Monitoring chaos at the cot-side Open
View article: Dysmaturation of sleep state and electroencephalographic activity after hypoxia-ischaemia in preterm fetal sheep
Dysmaturation of sleep state and electroencephalographic activity after hypoxia-ischaemia in preterm fetal sheep Open
Antenatal hypoxia-ischaemia (HI) in preterm fetal sheep can trigger delayed evolution of severe, cystic white matter injury (WMI), in a similar timecourse to WMI in preterm infants. We therefore examined how severe hypoxia-ischaemia affect…
View article: White matter protection with insulin-like growth factor-1 after hypoxia-ischaemia in preterm foetal sheep
White matter protection with insulin-like growth factor-1 after hypoxia-ischaemia in preterm foetal sheep Open
Perinatal hypoxia-ischaemia in extremely preterm infants is associated with long-term neurodevelopmental impairment, for which there is no specific treatment. Insulin-like growth factor-1 can reduce acute brain injury, but its effects on c…
View article: Suppressed or increased fetal heart rate variability: Which is more associated with intrapartum fetal compromise?
Suppressed or increased fetal heart rate variability: Which is more associated with intrapartum fetal compromise? Open
Sir, We read the article by Descourvieres and colleagues with great interest.1 In a cohort of 132 cases of severe acidemia, they identified 62 cases (47%) that showed an evolving pattern of hypoxia during labor. The description of the sequ…
View article: The neural and cardiovascular effects of exposure of gram-positive bacterial inflammation in preterm fetal sheep
The neural and cardiovascular effects of exposure of gram-positive bacterial inflammation in preterm fetal sheep Open
Perinatal infection or inflammation are associated with adverse neurodevelopmental effects and cardiovascular impairments in preterm infants. Most preclinical studies have examined the effects of gram-negative bacterial inflammation on the…
View article: An Update of Our Understanding of Fetal Heart Rate Patterns in Health and Disease
An Update of Our Understanding of Fetal Heart Rate Patterns in Health and Disease Open
UNDERSTANDING FETAL HEART RATE PATTERNS THAT MAY PREDICT ANTENATAL AND INTRAPARTUM NEURAL INJURY: Christopher A. Lear, Jenny A. Westgate, Austin Ugwumadu, Jan G. Nijhuis, Peter R. Stone, Antoniya Georgieva, Tomoaki Ikeda, Guido Wassink , L…
View article: Circadian patterns of heart rate variability in fetal sheep after hypoxia‐ischaemia: A biomarker of evolving brain injury
Circadian patterns of heart rate variability in fetal sheep after hypoxia‐ischaemia: A biomarker of evolving brain injury Open
Hypoxia‐ischaemia (HI) before birth is a key risk factor for stillbirth and severe neurodevelopmental disability in survivors, including cerebral palsy, although there are no reliable biomarkers to detect at risk fetuses that may have suff…
View article: The physiology of intrapartum fetal head compression
The physiology of intrapartum fetal head compression Open
View article: Prediction of Fetal Blood Pressure during Labour with Deep Learning Techniques
Prediction of Fetal Blood Pressure during Labour with Deep Learning Techniques Open
Our objective is to develop a model for the prediction of minimum fetal blood pressure (FBP) during fetal heart rate (FHR) decelerations. Experimental data from umbilical occlusions in near-term fetal sheep (2698 occlusions from 57 near-te…
View article: Table of Contents
Table of Contents Open
View article: Dissecting the contributions of the peripheral chemoreflex and myocardial hypoxia to fetal heart rate decelerations in near‐term fetal sheep
Dissecting the contributions of the peripheral chemoreflex and myocardial hypoxia to fetal heart rate decelerations in near‐term fetal sheep Open
Brief repeated fetal hypoxaemia during labour can trigger intrapartum decelerations of the fetal heart rate (FHR) via the peripheral chemoreflex or the direct effects of myocardial hypoxia, but the relative contribution of these two mechan…
View article: Magnesium sulphate reduces tertiary gliosis but does not improve EEG recovery or white or grey matter cell survival after asphyxia in preterm fetal sheep
Magnesium sulphate reduces tertiary gliosis but does not improve EEG recovery or white or grey matter cell survival after asphyxia in preterm fetal sheep Open
Maternal magnesium sulphate (MgSO 4 ) treatment is widely recommended before preterm birth for neuroprotection. However, this is controversial because there is limited evidence that MgSO 4 provides long‐term neuroprotection. Preterm fetal …
View article: Fetal heart rate responses in chronic hypoxaemia with superimposed repeated hypoxaemia consistent with early labour: a controlled study in fetal sheep
Fetal heart rate responses in chronic hypoxaemia with superimposed repeated hypoxaemia consistent with early labour: a controlled study in fetal sheep Open
Objective Deceleration area (DA) and capacity (DC) of the fetal heart rate can help predict risk of intrapartum fetal compromise. However, their predictive value in higher risk pregnancies is unclear. We investigated whether they can predi…
View article: Alpha-adrenergic receptor activation after fetal hypoxia-ischaemia suppresses transient epileptiform activity and limits loss of oligodendrocytes and hippocampal neurons
Alpha-adrenergic receptor activation after fetal hypoxia-ischaemia suppresses transient epileptiform activity and limits loss of oligodendrocytes and hippocampal neurons Open
Exposure to hypoxic-ischaemia (HI) is consistently followed by a delayed fall in cerebral perfusion. In preterm fetal sheep this is associated with impaired cerebral oxygenation, consistent with mismatch between perfusion and metabolism. I…
View article: Tumour necrosis factor blockade after asphyxia in foetal sheep ameliorates cystic white matter injury
Tumour necrosis factor blockade after asphyxia in foetal sheep ameliorates cystic white matter injury Open
Cystic white matter injury is highly associated with severe neurodevelopmental disability and cerebral palsy in preterm infants, yet its pathogenesis remains poorly understood and there is no established treatment. In the present study, we…
View article: Cerebral Oxygenation and Metabolism After Hypoxia-Ischemia
Cerebral Oxygenation and Metabolism After Hypoxia-Ischemia Open
Perinatal hypoxia-ischemia (HI) is still a significant contributor to mortality and adverse neurodevelopmental outcomes in term and preterm infants. HI brain injury evolves over hours to days, and involves complex interactions between the …
View article: Increased variability of fetal heart rate during labour: a review of preclinical and clinical studies
Increased variability of fetal heart rate during labour: a review of preclinical and clinical studies Open
Increased fetal heart rate variability (FHRV) in intrapartum cardiotocographic recording has been variably defined and poorly understood, limiting its clinical utility. Both preclinical (animal) and clinical (human) evidence support that i…
View article: Fetal heart rate variability is a biomarker of rapid but not progressive exacerbation of inflammation in preterm fetal sheep
Fetal heart rate variability is a biomarker of rapid but not progressive exacerbation of inflammation in preterm fetal sheep Open
Textbooks can be wrong—head compression is very unlikely to contribute to intrapartum decelerations Open
View article: Is Late Prevention of Cerebral Palsy in Extremely Preterm Infants Plausible?
Is Late Prevention of Cerebral Palsy in Extremely Preterm Infants Plausible? Open
Preterm birth continues to be associated with neurodevelopmental problems including cerebral palsy. Cystic white matter injury (WMI) is still the major neuropathology underlying cerebral palsy, affecting 1–3% of preterm infants. Although r…
View article: Reply to Smolich and Mynard
Reply to Smolich and Mynard Open
View article: Treating Seizures after Hypoxic-Ischemic Encephalopathy—Current Controversies and Future Directions
Treating Seizures after Hypoxic-Ischemic Encephalopathy—Current Controversies and Future Directions Open
Seizures are common in newborn infants with hypoxic-ischemic encephalopathy and are highly associated with adverse neurodevelopmental outcomes. The impact of seizure activity on the developing brain and the most effective way to manage the…
View article: Reply to “Letter to the Editor: Bezold–Jarisch reflex in the near-term fetus during labor: a matter of time”
Reply to “Letter to the Editor: Bezold–Jarisch reflex in the near-term fetus during labor: a matter of time” Open
View article: Reply to “Measurement of fetal parasympathetic activity during labor: a new pathway for evaluation of fetal well-being?”
Reply to “Measurement of fetal parasympathetic activity during labor: a new pathway for evaluation of fetal well-being?” Open
View article: Tertiary cystic white matter injury as a potential phenomenon after hypoxia-ischaemia in preterm f sheep
Tertiary cystic white matter injury as a potential phenomenon after hypoxia-ischaemia in preterm f sheep Open
White matter injury, including both diffuse and cystic elements, remains highly associated with neurodevelopmental disability and cerebral palsy in preterm infants, yet its pathogenesis and evolution are still poorly understood and there i…
View article: Letter to the editor regarding “The influence of melatonin on the heart rhythm – An in vitro simulation with murine embryonic stem cell derived cardiomyocytes”
Letter to the editor regarding “The influence of melatonin on the heart rhythm – An in vitro simulation with murine embryonic stem cell derived cardiomyocytes” Open
View article: Recombinant erythropoietin does not augment hypothermic white matter protection after global cerebral ischaemia in near-term fetal sheep
Recombinant erythropoietin does not augment hypothermic white matter protection after global cerebral ischaemia in near-term fetal sheep Open
Therapeutic hypothermia for hypoxic-ischaemic encephalopathy provides partial white matter protection. Recombinant erythropoietin reduces demyelination after hypoxia-ischaemia, but it is unclear whether adjunct erythropoietin treatment can…