Pericytes in Germinal Matrix Hemorrhage (GMH)

Intraventricular hemorrhage (IVH) and germinal matrix hemorrhage (GMH) are brain bleeds that contribute to brain damage in babies born prematurely. These bleeds can have a devastating impact on brain development over the baby's lifetime.

It is important to understand the biological cause of the bleed that can:

• Inform infant risk for developing these bleeds and associated secondary injuries
• Assess how well the baby recovers and the effectiveness of medical care
• Monitor the baby's condition
• Inspire the development of new therapies that could prevent or decrease brain damage for premature infants, particularly those of very low birth weight.

The study will test blood collected from the placenta cord after birth for the molecular signaling that may be related to pericytes stabilizing blood vessels. The blood is collected as part of the normal medical care to blood type newborns, and no direct interaction with the baby will occur.

Three groups of babies will be included:

• Full-term babies born at 37+ weeks to test for normal levels of molecular signals
• Preterm babies 31-36 weeks at low risk for brain bleeds
• Preterm babies 30 weeks or less that are at higher risk of developing brain bleeds

Protocol Description

This study will collect cord blood from the placenta of healthy term and preterm babies as is standard for blood typing for the baby. Instead of throwing the blood away, we will keep it and use the blood to look for molecular cues that may impact the development of GMH/IVH in preterm infants. Healthy babies will be a comparison group to preterm infants to determine a baseline measure of these molecular signals.

At days 7-14, all preterm infants are imaged via ultrasound to see if they have any brain bleeds that may have developed. If a baby has developed a bleed or GMH, we will follow the infant’s progress in the medical chart and ask for extra blood that is going to be taken from a blood draw that the baby is getting for standard medical care.

 If the bleed requires surgical intervention and placement of a shunt, we ask for the cerebrospinal fluid (CSF) that would normally be thrown away and then test CSF for molecular signals.