Hope for preemies: Estrogen treatment could prevent development issues

Hope for premature babies: Estrogen treatment straight after birth could prevent development issues

  • Premature birth raises the risks that a baby will face mental health and behavioral issues 
  • Key neurons that underlie these problems finish developing in the third trimester
  • Premature babies also get less estrogen exposure in the womb than full-term infants do 
  • The hormone plays a key role in neurodevelopment, previous research has shown 
  • Scientists at Children’s Hospital in the Bronx, New York, treated preterm baby rabbits with estrogen 
  • The treatment ‘corrected’ impaired brain cells that, when untreated, my cause autism and schizophrenia  

Treating premature babies with estrogen could ‘fix’ key neurons to save these infants from behavioral disorders and mental illness down the line, a new study suggests.

An early birth interrupts the development of key types of brain cells, called interneurons that coordinate communication between different parts of the brain. 

Problems with these neurons are implicated in disorders like autism and schizophrenia as well as other mental illnesses.  

Estrogen levels also peak in the third and final trimester, meaning that preterm babies do not get nearly as much exposure to this important hormone during development. 

Scientists at the Albert Einstein College of Medicine in New York found that by ‘recreating’ the womb environment by exposing preterm baby rabbits to estrogen after birth, they could set the development of those brain cells back on track. 

Estrogen treatment right after birth may ‘fix’ specialized neurons and protect premature infants from neurodevelopmental disorders, new research suggests 

Survival rates for babies born early – before a full 39 weeks in their mother’s womb – are now high and stable, but these infants still face a disproportionate number of health issues and risks for disabilities. 

Because a fetus keeps developing and changing rapidly in the unique incubator of the uterus right up to birth, premature babies are more likely to have heart and lung problems as well as social, behavioral and psychological issues later in their lives. 

These issues can come with dramatic fallout in the day-to-day lives of these children as they grow up. 

A British study published in 2015 even found that, among a cohort of adults born in 1970, those who were delivered early were 23 percent more likely to become manual laborers and 24 percent more likely to be unemployed. 

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The alarming ways that these people fall behind their full-term peers may be related to the fact that the earlier a baby is born, the more likely she or he is to suffer a neurodevelopmental disorder. 

Fetuses spend their gestation period bathed in amniotic fluid which contains all the right ingredients to help its body and brain develop. But some of these benefits are lost when the baby comes early. 

Among the ingredients in amniotic fluid is estrogen. The hormone’s levels steadily increase, starting as soon as a woman gets pregnant and peaking in the third trimester. 

Scientists have not yet worked out every single role that estrogen plays in development, but they suspect it is crucial to how the fetal brain grows and changes. 

When the doctors at Albert Einstein College of Medicine – Children’s Hospital in the Bronx, in New York, performed autopsies on the brains of premature infants that had died, they saw that they had abnormalities in certain types of interneurons. 

In particular, they were concerned with one subtype of interneurons, the parvalbumin cells. 

These specialized neurons were dubbed the ‘superhero cells’ by Boston Children’s Hospital, because this small population of cells coordinates all manner of brain activity and ensures plasticity. 

Parvalbumin cells make sure that all the right, minute windows of electrical activity in the brain line up just right. 

This ensures that the brain’s circuits can keep rewiring themselves, allowing for ‘plasticity,’ which is key to learning as well as mental health and social behavior. 

These cells finish developing in the third trimester and, when they don’t work properly, the brain is less flexible, and research suggests that this rigidity may underlie schizophrenia, autism and other mental illnesses.

And studies also suggest that estrogen in the womb helps to ensure healthy neurological development. Among its benefits, the hormone may aid the development of interneurons.

So, to mitigate the estrogen deficit faced in the womb, the researchers tried giving newborn preterm rabbits an extra dose of the hormone, bringing their exposures back up to what they should have been during gestation. 

This seemed to ‘fix’ the underdeveloped and dysfunctional interneurons. Estrogen’s effects on the all-imprortant ‘superhero’ parvalbumin cells were particularly drammatic

‘As preterm-birth drops plasma estrogen level 100-fold, estrogen replacement in extremely preterm infants might improve their developmental outcome and minimize neurobehavioral disorders,’ the authors wrote. 

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