Oxygen deprivation at birth: could a new type of 'gas and air' relieve mothers’ labour pains and protect babies?

Worldwide, nearly one quarter of babies who die within a month of birth lose their lives to a problem called birth asphyxia^1,2 – oxygen deprivation and a reduced blood supply to the brain around the time of birth that can cause brain damage. Dr Daqing Ma, of Imperial College London, believes a new type of ‘gas and air’ might have the potential to relieve mothers’ labour pains and save babies’ lives. He is investigating his suspicions in the laboratory.

What is the problem and who does it affect?

Around one in every 1,000 newborn babies in the UK dies or suffers severe brain damage due to birth asphyxia – that’s 700 babies every year.³ The problem also causes an estimated 250 stillbirths.⁴

Birth asphyxia is in fact a major cause of death and illness in babies worldwide. It can result from a variety of things during childbirth, including problems with the placenta or umbilical cord. Immediately after birth, it can be caused by an obstruction in the airways, for example.

‘If a baby develops birth asphyxia during childbirth, then his or her life is in immediate danger,’ explains Dr Ma. ‘Sadly, many babies are stillborn or die soon after birth. Babies who survive can develop life-long disabilities, such as cerebral palsy, learning disabilities, deafness and epilepsy, which can severely affect quality of life for these babies and their families.’

During labour, the only way to help babies with birth asphyxia is to deliver them urgently, by caesarean section for example. ‘New ways to help babies with birth asphyxia during childbirth are urgently needed, says Dr Ma.

What is the project trying to achieve?

Dr Ma is investigating whether some anaesthetics, which might relieve women’s labour pains during childbirth, might have the added benefit of protecting babies from the effects of birth asphyxia.

‘Gas and air’ is widely used during labour to provide pain relief,’ explains Dr Ma. ‘It contains an inhaled anaesthetic called nitrous oxide. However, preliminary evidence suggests two other anaesthetic gases, called argon and servoflurane, might have the power not only to provide pain relief, but also to protect babies from the effects of birth asphyxia. We are investigating this possibility in a laboratory model.’

Sevoflurane is already used on a daily basis to provide pain relief in other circumstances, which means that extensive data is already available on its safety. The ultimate aim is to find a simple, cost-effective way to protect babies around the world from the brain damage, death and disability that birth asphyxia can cause.

What are the researchers credentials?

Dr Ma and his colleagues are established leaders in researching how anaesthetics work and have extensive experience of caring for mothers and babies around the time of birth. Their work has been published in several leading journals and their laboratories contain state-of-the-art equipment that is ideally suited to this project.

References

1. Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? Where Why? Lancet 2005; 365(9462); 891-900.
2. Bryce J, et al. WHO estimates of the causes of death in children. Lancet 2005; 365:1147-52.
3. McGuire W. Perinatal asphyxia. ClinicalEvidence (Online) 2007; 2007: 0320. Published online 2007, November 7. Website accessed 30 January 2012. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943784/
4. CMACE, Perinatal mortality 2008, London 2010.