Advances in neuroprotection strategies for newborns
Keywords:
brain hypoxia-ischemia; neuroprotection; neurodevelopmental disorders; premature infantAbstract
Introduction: neurodevelopment and its executive function, essential for learning, face challenges associated with prematurity and perinatal conditions, mitigated through neuroprotective strategies.
Objective: to review updated information on advances in neuroprotection strategies for newborns.
Methods: a narrative bibliographic review was carried out using information published in different databases, in the period 2003-2025, in four languages. The following keywords were used: neonatal encephalopathy, brain injury, neurodevelopment, prematurity, and neuroprotection. A total of 143 articles were found, including systematic reviews, meta-analyses, e-books, and original articles. Thirty-eight studies that met the inclusion criteria were selected. Case studies and case series were excluded. Analytic-synthetic, historical-logical, and inductive-deductive theoretical methods were employed.
Development: five strategies are effective in premature neonates: prenatal corticosteroids, magnesium sulfate, delayed cord clamping, caffeine, and kangaroo mother care. Only therapeutic hypothermia is effective in newborns with hypoxic-ischemic encephalopathy. Emerging therapies explore solutions such as melatonin, erythropoietin, and stem cells to mitigate neurological damage associated with prematurity and optimize brain development. Therapeutic prospects for term neonates consider advanced options such as erythropoietin, melatonin, xenon, allopurinol and other promising molecules.
Conclusions: neonatal brain injury can result from developmental abnormalities in premature infants or damage to formed tissues in full-term neonates. Current strategies include corticosteroids, magnesium sulfate, delayed clamping, caffeine, and therapeutic hypothermia. Advances such as melatonin, erythropoietin, stem cells, noble gases, and allopurinol promise more personalized and effective therapies
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