Saving the unborn from cerebral palsy

Saving the unborn from cerebral palsy

Melbourne doctors may have found a way to prevent unborn babies from developing cerebral palsy, in a breakthrough that could protect the brains of hundreds of Australian children born with the condition each year.

In a world-first trial at Monash Medical Centre, pregnant women whose babies are not developing normally will be given an antioxidant that doctors believe will stop their babies from suffering brain damage in the womb.

About one in 20 women have a significantly growth-restricted baby, in which the placenta does not provide sufficient oxygen and nutrients for the developing brain.

The condition is a major cause of cerebral palsy, but there is currently nothing doctors can do to prevent it in the seven out of 10 cases where the brain injury occurs before birth.

Over the past five years, scientists at Monash have established that the brain injury is caused by oxidative stress, in which excess chemicals called free radicals damage normal tissues.

They have been able to prevent brain injuries to foetal lambs by giving their mothers the antioxidant melatonin, which corrected the oxidative stress.


Now the treatment is set to be offered to pregnant women, in what Southern Health director of obstetrics Euan Wallace said could be a major breakthrough to protect babies at risk of brain injury.

''It is significant because at the moment there is no treatment we can give women during pregnancy to protect their unborn baby's brain,'' he said.

''Pregnancy is a black box - we are watching, but until now there has been nothing we can do to intervene.''

Professor Wallace said he was seeking ethics approval for the trial which would initially involve giving melatonin tablets to about a dozen pregnant women with growth-restricted babies.

One woman who may have already benefited from the discovery is Megan Norbury, whose eldest child, Angus, 6, was born prematurely after doctors discovered he was struggling to survive inside the womb.

She fell pregnant again after three miscarriages, including at 19 weeks, and feared losing another baby. Doctors at Monash monitored her progress very closely and at 17 weeks she began taking an antioxidant available over-the-counter after being told it might help the baby's development. ''I would have stood on my head if it was going to work,'' she said. ''I needed to get to 24 weeks so I could deliver but no-one thought I was going to get that far.''

At 23 weeks, she had an ultrasound. ''The woman who scanned me said 'I've only ever seen this a few times in my career, that a baby improves from where your baby was'.''

Five weeks later her son, Saxon, was born, and is now a mostly healthy five-month-old. Mrs Norbury said taking the antioxidant was the only thing she had done differently with Saxon compared to her other pregnancies, and hoped the trial could help others.

Professor Wallace's team has already found that the level of free radicals are higher in the umbilical cord blood of growth-restricted babies compared with healthy babies. Now as part of the trial they will test the cord blood of babies whose mothers have been given melatonin to see if it has been successful in reducing oxidative stress.

If the treatment proves successful, Professor Wallace would then conduct a larger trial of about 100 women, including follow-ups when their children were two or three years to see if they developed cerebral palsy.

Details of the trial come as the federal government will announce today $71 million towards a Monash Health Translational Precinct that will fast-track the conversion of discoveries by scientists in the laboratory into new treatments for patients.

Professor Wallace said the cerebral palsy discovery, led by scientist Suzie Miller, was an example of what they were trying to achieve. ''One of the strengths of our research program is scientists and clinicians working together and having conversations every day of the week, understanding each others' business and together trying to address the same problems,'' he said.

Each year about 700 Australian children are born with cerebral palsy, which causes a range of physical disabilities and can be linked to other conditions, including epilepsy.

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