Prematurity is one of the major causes of death in newborns. Women who are at immediate risk of going into labour early are often given steroids to improve their baby's chance of survival should delivery occur prematurely. These drugs speed up the development of the unborn child, reducing the risk of potentially fatal health problems that occur because its lungs are not yet ready. As the steroids are always administered to the mother and not to the baby, it is important to compare and contrast the effects of giving steroids to the mother or to the unborn baby. The findings from this research may lead to doctors administering drugs directly to the baby inside the womb rather than to its mother.

Fetal brain activity studied using functional magnetic resonance imaging
Dr P A Gowland et al.
University of Nottingham

Every year in the UK around 1,000 babies are born with severe cerebral palsy and this is commonly the result of low birthweight or premature birth. The aim of this study is to examine the activity and development of a baby's brain in the womb and to use this knowledge to find preventative treatments for cerebral palsy as well as other developmental problems associated with low birth weight. Fetal brain development is critical to brain function in later life.

The ability to assess fetal brain activity before birth offers the potential of developing strategies aimed at addressing the developmental compromise associated with low birthweight and restricted growth in the womb. The results of this study will have applications in future work on fetal learning.

Project to assess the differences in the placentas of growth-restricted and normal pregnancies giving more information about how the placenta works
Dr S W D'Souza
Academic Unit of Child Health, St Mary's Hospital, Manchester

Babies who are small at birth may have been born too early, others may have grown slowly in the womb. The placenta should normally supply the growing baby with oxygen and nutrients. If something in this process goes wrong the baby may not receive enough oxygen, causing raised levels of acid and lactate in the baby. This is dangerous for the baby as it can result in brain damage. The placenta normally plays a role in transporting away from the baby as well as to the baby (e.g. taking away excess toxic molecules), but this does not seem to happen in growth-restricted babies. This project aims to compare placentas from growth-restricted babies and healthy babies to study the differences. Information gained from this research may lead to the development of a treatment for this problem.

After the first year of the study, the research team are on course to complete their objectives, having successfully established a method for measuring the transport of lactate and to begin studies on placenta from growth-restricted pregnancies.

The over-production of nitric oxide in the brain and its possible role in causing brain damage
Dr C Cooper & Prof J Wyatt
University of Essex & University College London

A lack of oxygen to the brain at around the time of birth is responsible for brain damage or death in thousands of babies. This project aims to understand the processes at work in controlling the flow of oxygen to the brain and devise new methods for predicting how severe brain damage will be if it is likely to occur. By assessing the risk for these babies, it may one day be possible to prevent brain damage or death occurring.

Nitric oxide was originally thought to be an environmental pollutant (for example from car exhausts) but is now known to be a vital molecule in the body, acting as a messenger to trigger a number of important physiological processes such as blood flow and memory. However, too much nitric oxide in the wrong place can be toxic and studies have shown that nitric oxide levels increase during and after the brain is denied oxygen.

This excess nitric oxide may play a role in brain damage and it is thought that it may be a marker of how severe the brain damage will be. This team will measure nitric oxide levels in the unborn baby after a lack of oxygen to the brain. This study may also shed light on the differences in the mechanism of brain damage in premature infants and babies born at term.

Some evidence has been found that nitric oxide production is less extensive in the fetal brain than in the neonatal brain and this work will be extended further over the course of this project. This may relate to the different mechanisms of brain damage in the premature and term baby following birth asphyxia

Research to improve the understanding and prevention of premature labour
Research on understanding and preventing stillbirth and miscarriage
Research to improve the understanding and prevention of pre-eclampsia
Research to prevent health problems in small or premature babies