American neurologist Donna M. Ferriero delivers 33rd T.S.Srinivasan Endowment oration

Pointing out the high incidence of pre-term births and associated neuro-development disorders in India and other developing countries, Prof. Donna M. Ferriero, a U.S. paediatric neurologist, called for “a focussed approach to the care of the impaired, irrespective of the gestational age.”

Care included better monitoring of the newborn brain with amplitude-integrated and continuous EEG, prevention of infection, and family-centred care.

“Focussed care increases the possibility of better identification of one of the risks of a progressive brain injury,” Dr. Ferriero, professor of pediatrics and chair of Department of Pediatrics and Physician-in-Chief of the University of California, San Franciso, said.

Delivering the 33rd T.S.Srinivasan Endowment oration on the topic ‘The newborn with a vulnerable brain: a 21st century view of neuroprotection and repair’ in Chennai on Saturday, Ms. Ferriero shed light on the brain-focused care for the newborn, and the criticality of early recognition and diagnosis.

“What happens early in life,” she said, “affects the future in terms of brain development. In the world we live in, there is a rise in the number of babies that are born with Neurodevelopment Disorders (NDD). It is a pressing concern.”

“The first six hours of life are crucial. It is important to assess the blood parameters, check oxygen level of the baby and in general, observe how the baby responds to external stimuli.” This kind of a focussed, collaborative clinical effort between neonatologists and neurologists, combined with training in neonatal neurology for nurses, can go a great deal towards avoiding further injury and improve long-term neurodevelopmental outcomes,” she said.

Factors that compromise the developing brain affect maternal health around conception and through the period of pregnancy. Trauma through injury, drugs (both prescription and non-prescription), alcohol, smoking, infections, exposure to toxins and maternal malnutrition commonly compromise this desired state of "optimality".

Other factors that compromise optimality include peri-natal trauma and infection through poorly planned or executed delivery of the child into this world; neonatal compromise (asphyxiation, jaundice, early trauma through accidents or abuse, infections, malnutrition); untreated epilepsy and other conditions of the brain that can progressively impact brain function.

The T S Srinivasan Oration and award is sponsored by the T S Srinivasan Charitable Trust through the T S Srinivasan Institute at Voluntary Health Services (VHS). On the occasion of delivering the endowment lecture, Venu Srinivasan, chairman, TVS Motor Company, presented the T.S.Srinivasan medal and scroll to Prof.Ferriero. Prof. Krishnamoorthy Srinivas, chairman emeritus, T.S.Srinivasan Institute of Neuro-sciences, Dr. E.S. Krishnamoorthy, T.S.Srinivasan Chair and Dr.S.Suresh, honorary secretary, VHS were also present.