How did you get into research, why this area?
I am a child neurologist and study brain injury in babies as well as stroke and cerebral palsy. However, when I started I had never really studied brain injury and cerebral palsy as a maternal/pregnancy/fetal issue. I realized that in order to understand brain injury in a baby I needed to understand both the mother and child.
I also became interested in this because of the stigma for kids with CP, and also knowing there is a true range – some kids are in wheelchairs, some have mild motor problems, and some have normal motor function but exhibit learning disabilities. These kids have a hard time adjusting their whole lives, which impacts their care and their place in society.
The other reason I became passionate about this area of research is the long term consequences on the individuals in the family unit; especially the mother. Once a child is born with stroke that leads to CP, the mother or caretaker has to take off work or leave her job to care for the child This can have a big impact on the social dynamic environment of the household, sometimes with divorce and family separation resulting from the pressures.
So this disease impacts not only the individual child, but family and society as well.
Why is this important?
It has only been in the past 15 years or so that pediatric stroke has been recognized as the major contributor to CP thanks to imaging and higher awareness about looking at stroke and brain injury in children.
We still don’t really know what actually triggers the stroke, and we want to get the root of the problem in pregnant women to prevent stroke if we can. We do know some risk factors but they are all from all retrospective studies. I want to look forward and understand whether inflammatory markers are causing it.
What is the incidence of CP/Fetal Stroke:
- Fetal Stroke: 1 in 2000; prevalence, because we don’t know the underlying denominator. About the best guess.
- CP: 1 in 1000 births. 100,000 children a year; about 800,000 living with CP at any moment in time.
Of the children born with stroke, only one third live normal lives; two-thirds have lasting neurological disabilities.
It’s important that we understand brain injury at the time of birth is a lifetime injury, and the lifetime cost of a baby born with CP or brain injury is almost $1 million compared with an adult with stroke which is $90,000. This doesn’t take into account hospital or in-home care or respite, which means the family and society carry a heavy financial burden for the life of the child.
What are your hopes and dreams for your research?
The arc of research is probably 20 years – it will be a long process to understand what this means and we are just getting preliminary data. I do want to be sure to recognize the importance of collaboration through the BIRCWH grant funding, which has been instrumental in pulling other mentors into place.
Ultimately my hope is that we will be able to measure the blood in high risk mothers that will show whether they are at highest risk to have a child with a brain injury, and then to have an actual intervention strategy or therapy to prevent it.
My grant through the CWHR is to look at the clotting profile of moms and babies. What would be really neat is to be able to look at the clotting factor in pregnant women because clotting is the biggest factor for stroke even up to one year after the pregnancy. And then we would follow the group and look at their clotting profiles later in life to see if there is increased risk for cardiovascular or heart disease. This could ultimately become a screening tool which could classify women into high and low risk for CVD.
My other hope and dream is to increase awareness and care for kids with CP. By recognizing this condition early in life, we can start interventions such as physical and occupational therapy, which has life-long implications. Sometimes these kisget lost in the woodwork. CP is not a scary disease. What scares me is not giving kids and their families the best chance possible for success.
To learn more about the BIRCWH program at University of Colorado Anschutz Medical Campus, click here: