docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2024-23-3-49-54docru-161Research ArticleОБЗОРЫREVIEWSСтратегия перинатальной нейропротекции у детей: современное состояние проблемы и перспективыPerinatal Neuroprotection Strategy in Children: Current State of the Problem and Prospectshttps://orcid.org/0000-0002-6444-1871ПавлиноваЕ. Б.PavlinovaE. B.

Павлинова Елена Борисовна — д. м. н., профессор, заведующая кафедрой госпитальной педиатрии с курсом ДПО, проректор по учебной работе

644001, г. Омск, ул. Куйбышева, д. 77

77 Kuybyshev Str., Omsk, 644001

123elena@mail.ruhttps://orcid.org/0000-0002-5446-2126ГубичА. А.GubichA. A.

Губич Анастасия Андреевна — к. м. н., ассистент кафедры госпитальной педиатрии с курсом ДПО

644001, г. Омск, ул. Куйбышева, д. 77

77 Kuybyshev Str., Omsk, 644001

nastya930108@mail.ruhttps://orcid.org/0000-0003-2035-5653СавченкоА. А.SavchenkoO. A.

Савченко Ольга Анатольевна — к. м. н., доцент кафедры госпитальной педиатрии с курсом ДПО

644001, г. Омск, ул. Куйбышева, д. 77

77 Kuybyshev Str., Omsk, 644001

olgasav1978@mail.ruФГБОУ ВО «Омский государственный медицинский университет» Минздрава РоссииРоссияOmsk State Medical UniversityRussian Federation202417022025233ПЕДИАТРИЯ4954Copyright © Павлинова Е.Б., Губич А.А., Савченко А.А., 20252025Павлинова Е.Б., Губич А.А., Савченко А.А.Pavlinova E.B., Gubich A.A., Savchenko O.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/161Цель обзора

Цель обзора. Определить существующие возможности защиты головного мозга у детей при неблагоприятном течении перинатального периода.

Основные положения

Основные положения. Поражения центральной нервной системы являются одними из наиболее распространенных патологических состояний в периоде новорожденности. В статье представлены современные данные по патогенезу перинатальной травмы головного мозга. Дана характеристика различных терапевтических и профилактических стратегий перинатальной нейропротекции, описаны современные методики, препараты-кандидаты для ее обеспечения. Особое внимание уделено их механизмам действия, а также преимуществам и недостаткам.

Заключение

Заключение. Дополнительные стратегии для предупреждения и терапии поражений головного мозга крайне необходимы для улучшения исхода и прогноза у недоношенных и доношенных новорожденных детей.

Aim

Aim. To determine the existing possibilities for protecting the brain in children during an unfavorable course of the perinatal period.

Key points

Key points. Injury of the central nervous system are one of the most common pathological conditions in the neonatal period. The article presents modern data on the pathogenesis of perinatal brain injury. Characteristics of various therapeutic and preventive strategies for perinatal neuroprotection are given, modern methods and candidate drugs for providing it are described. Particular attention is paid to their mechanisms of action, as well as advantages and disadvantages.

Conclusion

Conclusion. Additional strategies for the prevention and treatment of brain injury are urgently needed for improve the outcome and prognosis of preterm and full-term neonates.

новорожденные детиперинатальная нейропротекциявнутрижелудочковые кровоизлиянияперивентрикулярная лейкомаляцияnewbornsperinatal neuroprotectionintraventricular hemorrhagesperiventricular leukomalaciaРабота выполнена при финансовой поддержке РФФИ в рамках научного проекта № 20-315-90067.The reported study was funded by RFBR, project number 20-315-90067.ReferencesLeijser L.M., de Vries L.S. Preterm brain injury: germinal matrix-intraventricular hemorrhage and post-hemorrhagic ventricular dilatation. Handb. Clin. Neurol. 2019;162:173–99. DOI: 10.1016/B978-0-444-64029-1.00008-4Leijser L.M., de Vries L.S. Preterm brain injury: germinal matrix-intraventricular hemorrhage and post-hemorrhagic ventricular dilatation. Handb. Clin. Neurol. 2019;162:173–99. DOI: 10.1016/B978-0-444-64029-1.00008-4McNally M.A., Soul J.S. Pharmacologic prevention and treatment of neonatal brain injury. Clin. Perinatol. 2019;46(2):311–25. DOI: 10.1016/j.clp.2019.02.006McNally M.A., Soul J.S. Pharmacologic prevention and treatment of neonatal brain injury. Clin. Perinatol. 2019;46(2):311–25. DOI: 10.1016/j.clp.2019.02.006Bersani I., Pluchinotta F., Dotta A., Savarese I. et al. Early predictors of perinatal brain damage: the role of neurobiomarkers. Clin. Chem. Lab. Med. 2020;58(4):471–86. DOI: 10.1515/cclm-2019-0725Bersani I., Pluchinotta F., Dotta A., Savarese I. et al. Early predictors of perinatal brain damage: the role of neurobiomarkers. Clin. Chem. Lab. Med. 2020;58(4):471–86. DOI: 10.1515/cclm-2019-0725Cаnovas-Ahedo M., Alonso-Alconada D. Terapia combinada frente a la encefalopatia hipоxico-isquеmica neonatal [Combined therapy in neonatal hypoxic-ischaemic encephalopathy]. An. Pediatr. (Engl. Ed.). 2019;91(1):59.e1–7. DOI: 10.1016/j.anpedi.2019.04.007Cаnovas-Ahedo M., Alonso-Alconada D. Terapia combinada frente a la encefalopatia hipоxico-isquеmica neonatal [Combined therapy in neonatal hypoxic-ischaemic encephalopathy]. An. Pediatr. (Engl. Ed.). 2019;91(1):59.e1–7. DOI: 10.1016/j.anpedi.2019.04.007Silveira R.C., Procianoy R.S. Hypothermia therapy for newborns with hypoxic ischemic encephalopathy. J. Pediatr. (Rio J.). 2015; 91(6 suppl.1):S78–83. DOI: 10.1016/j.jped.2015.07.004Silveira R.C., Procianoy R.S. Hypothermia therapy for newborns with hypoxic ischemic encephalopathy. J. Pediatr. (Rio J.). 2015; 91(6 suppl.1):S78–83. DOI: 10.1016/j.jped.2015.07.004Carreras N., Alsina M., Alarcon A., Arca-Diaz G. et al. Efficacy of passive hypothermia and adverse events during transport of asphyxiated newborns according to the severity of hypoxic-ischemic encephalopathy. J. Pediatr. (Rio J.). 2018;94(3):251–7. DOI: 10.1016/j.jped.2017.05.009Carreras N., Alsina M., Alarcon A., Arca-Diaz G. et al. Efficacy of passive hypothermia and adverse events during transport of asphyxiated newborns according to the severity of hypoxic-ischemic encephalopathy. J. Pediatr. (Rio J.). 2018;94(3):251–7. DOI: 10.1016/j.jped.2017.05.009Иова А.С., ред. Внутрижелудочковые кровоизлияния у недоношенных новорожденных. Основы персонализированной медицинской помощи: учебное пособие. СПб.: СпецЛит; 2020. 64 с.Iova A.S., ed. Intraventricular hemorrhages in premature newborns. Fundamentals of personalized medical care: a textbook. SPb.: SpetsLit; 2020. 64 p. (in Russian)Lim J., Hagen E. Reducing germinal matrix-intraventricular hemorrhage: perinatal and delivery room factors. Neoreviews. 2019;20(8):e452–63. DOI: 10.1542/neo.20-8-e452Lim J., Hagen E. Reducing germinal matrix-intraventricular hemorrhage: perinatal and delivery room factors. Neoreviews. 2019;20(8):e452–63. DOI: 10.1542/neo.20-8-e452Handley S.C., Passarella M., Lee H.C., Lorch S.A. Incidence trends and risk factor variation in severe intraventricular hemorrhage across a population based cohort. J. Pediatr. 2018;200:24–9.e3. DOI: 10.1016/j.jpeds.2018.04.020Handley S.C., Passarella M., Lee H.C., Lorch S.A. Incidence trends and risk factor variation in severe intraventricular hemorrhage across a population based cohort. J. Pediatr. 2018;200:24–9.e3. DOI: 10.1016/j.jpeds.2018.04.020Romantsik O., Bruschettini M., Moreira A., Thеbaud B. et al. Stem cell-based interventions for the prevention and treatment of germinal matrix-intraventricular haemorrhage in preterm infants. Cochrane Database Syst. Rev. 2019;9(9):CD013201. DOI: 10.1002/14651858.CD013201.pub2Romantsik O., Bruschettini M., Moreira A., Thеbaud B. et al. Stem cell-based interventions for the prevention and treatment of germinal matrix-intraventricular haemorrhage in preterm infants. Cochrane Database Syst. Rev. 2019;9(9):CD013201. DOI: 10.1002/14651858.CD013201.pub2Софронова Л.Н., Фёдорова Л.А. Недоношенный ребенок. Справочник. М.: Редакция журнала StatusPraesens; 2020. 312 с.Sofronova L.N., Fedorova L.A. Premature baby. Directory. M.: Editorial board of the StatusPraesens; 2020. 312 p. (in Russian)Гузева В.И., Иванов Д.О., Александрович Ю.С., Пальчик А.Б. и др. Неотложная неврология новорожденных и детей раннего возраста. СПб.: СпецЛит; 2017. 215 с.Guzeva V.I., Ivanov D.O., Aleksandrovich Yu.S., Palchik A.B. et al. Emergency neurology of newborns and young children. SPb.: SpetsLit; 2017. 215 p. (in Russian)Boyle A.K., Rinaldi S.F., Norman J.E., Stock S.J. Preterm birth: inflammation, fetal injury and treatment strategies. J. Reprod. Immunol. 2017;119:62–6. DOI: 10.1016/j.jri.2016.11.008Boyle A.K., Rinaldi S.F., Norman J.E., Stock S.J. Preterm birth: inflammation, fetal injury and treatment strategies. J. Reprod. Immunol. 2017;119:62–6. DOI: 10.1016/j.jri.2016.11.008Leviton A., Allred E.N., Dammann O., Engelke S. et al. Systemic inflammation, intraventricular hemorrhage, and white matter injury. J. Child. Neurol. 2013;28(12):1637–45. DOI: 10.1177/0883073812463068Leviton A., Allred E.N., Dammann O., Engelke S. et al. Systemic inflammation, intraventricular hemorrhage, and white matter injury. J. Child. Neurol. 2013;28(12):1637–45. DOI: 10.1177/0883073812463068Qin X., Cheng J., Zhong Y., Mahgoub O.K. et al. Mechanism and treatment related to oxidative stress in neonatal hypoxic-ischemic encephalopathy. Front. Mol. Neurosci. 2019;12:88. DOI: 10.3389/fnmol.2019.00088Qin X., Cheng J., Zhong Y., Mahgoub O.K. et al. Mechanism and treatment related to oxidative stress in neonatal hypoxic-ischemic encephalopathy. Front. Mol. Neurosci. 2019;12:88. DOI: 10.3389/fnmol.2019.00088van Westering-Kroon E., Huizing M.J., Villamor-Martinez E., Villamor E. Male disadvantage in oxidative stress-associated complications of prematurity: a systematic review, meta-analysis and meta-regression. Antioxidants (Basel). 2021;10(9):1490. DOI: 10.3390/antiox10091490van Westering-Kroon E., Huizing M.J., Villamor-Martinez E., Villamor E. Male disadvantage in oxidative stress-associated complications of prematurity: a systematic review, meta-analysis and meta-regression. Antioxidants (Basel). 2021;10(9):1490. DOI: 10.3390/antiox10091490Perez M., Robbins M.E., Revhaug C., Saugstad O.D. Oxygen radical disease in the newborn, revisited: oxidative stress and disease in the newborn period. Free Radic. Biol. Med. 2019;142:61–72. DOI: 10.1016/j.freeradbiomed.2019.03.035Perez M., Robbins M.E., Revhaug C., Saugstad O.D. Oxygen radical disease in the newborn, revisited: oxidative stress and disease in the newborn period. Free Radic. Biol. Med. 2019;142:61–72. DOI: 10.1016/j.freeradbiomed.2019.03.035Marseglia L., D'Angelo G., Manti S., Arrigo T. et al. Oxidative stress-mediated aging during the fetal and perinatal periods. Oxid. Med. Cell. Longev. 2014;2014:358375. DOI: 10.1155/2014/358375Marseglia L., D'Angelo G., Manti S., Arrigo T. et al. Oxidative stress-mediated aging during the fetal and perinatal periods. Oxid. Med. Cell. Longev. 2014;2014:358375. DOI: 10.1155/2014/358375Torres-Cuevas I., Parra-Llorca A., Sanchez-Illana A., Nunez-Ramiro A. et al. Oxygen and oxidative stress in the perinatal period. Redox. Biol. 2017;12:674–81. DOI: 10.1016/j.redox.2017.03.011Torres-Cuevas I., Parra-Llorca A., Sanchez-Illana A., Nunez-Ramiro A. et al. Oxygen and oxidative stress in the perinatal period. Redox. Biol. 2017;12:674–81. DOI: 10.1016/j.redox.2017.03.011Glover Williams A., Odd D., Bates S., Russell G. et al. Elevated international normalized ratio (INR) is associated with an increased risk of intraventricular hemorrhage in extremely preterm infants. J. Pediatr. Hematol. Oncol. 2019;41(5):355–60. DOI: 10.1097/MPH.0000000000001509Glover Williams A., Odd D., Bates S., Russell G. et al. Elevated international normalized ratio (INR) is associated with an increased risk of intraventricular hemorrhage in extremely preterm infants. J. Pediatr. Hematol. Oncol. 2019;41(5):355–60. DOI: 10.1097/MPH.0000000000001509Hochart A., Nuytten A., Pierache A., Bauters А. et al. Hemostatic profile of infants with spontaneous prematurity: can we predict intraventricular hemorrhage development? Ital. J. Pediatr. 2019;45(1):113. DOI: 10.1186/s13052-019-0709-8Hochart A., Nuytten A., Pierache A., Bauters А. et al. Hemostatic profile of infants with spontaneous prematurity: can we predict intraventricular hemorrhage development? Ital. J. Pediatr. 2019;45(1):113. DOI: 10.1186/s13052-019-0709-8Poralla C., Traut C., Hertfelder H.J., Oldenburg J. et al. The coagulation system of extremely preterm infants: influence of perinatal risk factors on coagulation. J. Perinatol. 2012;32(11):869–73. DOI: 10.1038/jp.2011.182Poralla C., Traut C., Hertfelder H.J., Oldenburg J. et al. The coagulation system of extremely preterm infants: influence of perinatal risk factors on coagulation. J. Perinatol. 2012;32(11):869–73. DOI: 10.1038/jp.2011.182Милованова О.А., Амирханова Д.Ю., Миронова А.К., Джуккаева М.М. и др. Риски формирования неврологической патологии у глубоконедоношенных детей: обзор литературы и клинические случаи. Медицинский совет. 2021;1:20–9.Milovanova O.A., Amirkhanova D.Yu., Mironova A.K., Dzhukkayeva M.M. et al. The risk of forming neurological disease in extremely premature infants: a review of literature and clinical cases. Medical Council. 2021;1: 20–9. (in Russian). DOI: 10.21518/2079-701X-2021-1-20-29Пальчик А.Б., Фёдорова Л.А., Понятишин А.Е. Внутрижелудочковые кровоизлияния у новорожденных детей. Методические рекомендации. СПб.; 2019. 50 с.Palchik A.B., Fedorova L.A., Ponyatishin A.E. Intraventricular hemorrhages in newborns. Guidelines. SPb.; 2019. 50 p. (in Russian)Bauer C.M., Papadelis C. Alterations in the structural and functional connectivity of the visuomotor network of children with periventricular leukomalacia. Semin. Pediatr. Neurol. 2019;31: 48–56. DOI: 10.1016/j.spen.2019.05.009Bauer C.M., Papadelis C. Alterations in the structural and functional connectivity of the visuomotor network of children with periventricular leukomalacia. Semin. Pediatr. Neurol. 2019;31: 48–56. DOI: 10.1016/j.spen.2019.05.009Singhi S., Johnston M. Recent advances in perinatal neuroprotection. F1000Res. 2019;8:F1000. DOI: 10.12688/f1000research.20722.1Singhi S., Johnston M. Recent advances in perinatal neuroprotection. F1000Res. 2019;8:F1000. DOI: 10.12688/f1000research.20722.1Володин Н.Н., ред. Клинические рекомендации: ведение новорожденных с респираторным дистресс-синдромом. 2016. 48 с.Volodin N.N., ed. Clinical guidelines: management of newborns with respiratory distress syndrome. 2016. 48 p. (in Russian)Shepherd E., Salam R.A., Middleton P., Makrides M. et al. Antenatal and intrapartum interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews. Cochrane Database Syst. Rev. 2017;8(8):CD012077. DOI: 10.1002/14651858.CD012077.pub2Shepherd E., Salam R.A., Middleton P., Makrides M. et al. Antenatal and intrapartum interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews. Cochrane Database Syst. Rev. 2017;8(8):CD012077. DOI: 10.1002/14651858.CD012077.pub2Shepherd E., Salam R.A., Middleton P., Han S. et al. Neonatal interventions for preventing cerebral palsy: an overview of Cochrane Systematic Reviews. Cochrane Database Syst. Rev. 2018;6(6):CD012409. DOI: 10.1002/14651858.CD012409.pub2Shepherd E., Salam R.A., Middleton P., Han S. et al. Neonatal interventions for preventing cerebral palsy: an overview of Cochrane Systematic Reviews. Cochrane Database Syst. Rev. 2018;6(6):CD012409. DOI: 10.1002/14651858.CD012409.pub2Chollat C., Marret S. Magnesium sulfate and fetal neuroprotection: overview of clinical evidence. Neural. Regen. Res. 2018;13(12): 2044–9. DOI: 10.4103/1673-5374.241441Chollat C., Marret S. Magnesium sulfate and fetal neuroprotection: overview of clinical evidence. Neural. Regen. Res. 2018;13(12): 2044–9. DOI: 10.4103/1673-5374.241441Lingam I., Robertson N.J. Magnesium as a neuroprotective agent: a review of its use in the fetus, term infant with neonatal encephalopathy, and the adult stroke patient. Dev. Neurosci. 2018;40(1):1–12. DOI: 10.1159/000484891Lingam I., Robertson N.J. Magnesium as a neuroprotective agent: a review of its use in the fetus, term infant with neonatal encephalopathy, and the adult stroke patient. Dev. Neurosci. 2018;40(1):1–12. DOI: 10.1159/000484891Pluta R., Furmaga-Jablonska W., Januszewski S., Tarkowska A. Melatonin: a potential candidate for the treatment of experimental and clinical perinatal asphyxia. Molecules. 2023;28(3):1105. DOI: 10.3390/molecules28031105Pluta R., Furmaga-Jablonska W., Januszewski S., Tarkowska A. Melatonin: a potential candidate for the treatment of experimental and clinical perinatal asphyxia. Molecules. 2023;28(3):1105. DOI: 10.3390/molecules28031105Solevag A.L., Schmolzer G.M., Cheung P.Y. Novel interventions to reduce oxidative-stress related brain injury in neonatal asphyxia. Free Radic. Biol. Med. 2019;142:113–22. DOI: 10.1016/j.freeradbiomed.2019.04.028Solevag A.L., Schmolzer G.M., Cheung P.Y. Novel interventions to reduce oxidative-stress related brain injury in neonatal asphyxia. Free Radic. Biol. Med. 2019;142:113–22. DOI: 10.1016/j.freeradbiomed.2019.04.028Laptook A.R. Birth asphyxia and hypoxic-ischemic brain injury in the preterm infant. Clin. Perinatol. 2016;43(3):529–45. DOI: 10.1016/j.clp.2016.04.010Laptook A.R. Birth asphyxia and hypoxic-ischemic brain injury in the preterm infant. Clin. Perinatol. 2016;43(3):529–45. DOI: 10.1016/j.clp.2016.04.010Неъматов Г.Х., Агашков В.С., Верещинский А.М., Макарова Т.Л. Гипотермия. За грань возможного. Здравоохранение Югры: опыт и инновации. 2021;4(29):15–23.Nematov G.Kh., Agashkov V.S., Vereshchinsky A.M., Makarova T.L. Hypothermia. Beyond the limits of the possible. Healthcare of Ugra: Experience and Innovations. 2021;4(29):15–23. (in Russian)Ленюшкина А.А., Андреев А.В., Шарафутдинова Д.Р., Крог-Йенсен О.А. Кофеина цитрат в неонатологии: история применения, особенности фармакодинамики и фармакокинетики, клинические эффекты, режимы дозирования (обзор литературы). Неонатология: новости, мнения, обучение. 2023;11(1): 76–82.Lenyushkina A.A., Andreyev A.V., Sharafutdinova D.R., Krogh-Jensen O.A. Caffeine citrate in neonatology: history, pharmacodynamics and pharmacokinetics, clinical effects, dosage regimens: a review. Neonatology: News, Opinions, Training. 2023;11(1):76–82. (in Russian). DOI: 10.33029/2308-2402-2023-11-1-76-82Frymoyer A., Juul S.E., Massaro A.N., Bammler T.K. et al. High-dose erythropoietin population pharmacokinetics in neonates with hypoxic-ischemic encephalopathy receiving hypothermia. Pediatr. Res. 2017;81(6):865–72. DOI: 10.1038/pr.2017.15Frymoyer A., Juul S.E., Massaro A.N., Bammler T.K. et al. High-dose erythropoietin population pharmacokinetics in neonates with hypoxic-ischemic encephalopathy receiving hypothermia. Pediatr. Res. 2017;81(6):865–72. DOI: 10.1038/pr.2017.15Juul S.E., Comstock B.A., Heagerty P.J., Mayock D.E. et al. High-dose erythropoietin for asphyxia and encephalopathy (HEAL): a randomized controlled trial — background, aims, and study protocol. Neonatology. 2018;113(4):331–8. DOI: 10.1159/000486820Juul S.E., Comstock B.A., Heagerty P.J., Mayock D.E. et al. High-dose erythropoietin for asphyxia and encephalopathy (HEAL): a randomized controlled trial — background, aims, and study protocol. Neonatology. 2018;113(4):331–8. DOI: 10.1159/000486820Ighodaro O.M., Akinloye O.A. First line defence antioxidants superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX): their fundamental role in the entire antioxidant defence grid. Alexandria J. Med. 2018;54(4):287–93. DOI: 10.1016/j.ajme.2017.09.001Ighodaro O.M., Akinloye O.A. First line defence antioxidants superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX): their fundamental role in the entire antioxidant defence grid. Alexandria J. Med. 2018;54(4):287–93. DOI: 10.1016/j.ajme.2017.09.001Younus H. Therapeutic potentials of superoxide dismutase. Int. J. Health. Sci. (Qassim). 2018;12(3):88–93Younus H. Therapeutic potentials of superoxide dismutase. Int. J. Health. Sci. (Qassim). 2018;12(3):88–93Scafidi J., Hammond T.R., Scafidi S., Ritter J. et al. Intranasal epidermal growth factor treatment rescues neonatal brain injury. Nature. 2014;506(7487):230–4. DOI: 10.1038/nature12880Scafidi J., Hammond T.R., Scafidi S., Ritter J. et al. Intranasal epidermal growth factor treatment rescues neonatal brain injury. Nature. 2014;506(7487):230–4. DOI: 10.1038/nature12880Volpe J.J. Dysmaturation of premature brain: importance, cellular mechanisms, and potential interventions. Pediatr. Neurol. 2019;95:42–66. DOI: 10.1016/j.pediatrneurol.2019.02.016Volpe J.J. Dysmaturation of premature brain: importance, cellular mechanisms, and potential interventions. Pediatr. Neurol. 2019;95:42–66. DOI: 10.1016/j.pediatrneurol.2019.02.016Ahn S.Y., Park W.S., Sung S.I., Chang Y.S. Mesenchymal stem cell therapy for intractable neonatal disorders. Pediatr. Neonatol. 2021;62(suppl.1):S16–21. DOI: 10.1016/j.pedneo.2020.11.007Ahn S.Y., Park W.S., Sung S.I., Chang Y.S. Mesenchymal stem cell therapy for intractable neonatal disorders. Pediatr. Neonatol. 2021;62(suppl.1):S16–21. DOI: 10.1016/j.pedneo.2020.11.007Thebaud B. Stem cells for extreme prematurity. Am. J. Perinatol. 2019;36(suppl.02):S68–73. DOI: 10.1055/s-0039-1691774Thebaud B. Stem cells for extreme prematurity. Am. J. Perinatol. 2019;36(suppl.02):S68–73. DOI: 10.1055/s-0039-1691774

The authors declare that there are no conflicts of interest present.