Premature birth is a major problem, affecting more than 1 in 10 babies globally. Currently, infants born between 28 and 37 weeks are housed within neonatal intensive care units (NICUs) which support their cardiorespiratory function and development to full term. This solution, however, yields severe health complications for infants born extremely premature, i.e. <28 weeks, as their organs lack maturity to undergo the complex physiologic transition to extra-uterine life.

The exposure to air is a harsh physiologic adaptation for extremely premature infants, and leads to numerous complication including breathing, cardiac, neurological and metabolic problems, with negative long-term outcome. Despite advances in medicine, for extremly premature infants NICUs are not an adequate substitute for the protective environment of the maternal womb.

Project website Perinatal Life Support

The researchers in this project envision a solution where the intra-uterine environment can be preserved extracorporeally by transferring the extremely premature infant to a perinatal life support system, with the goal to delay and ease the transition to newborn life. Only then can the fetal organs further develop until they reach maturity.

With the perinatal life support solution, the supply of oxygen and nutrients would be maintained through the fetal umbilical cord, connected to an artificial placenta. A liquid-based environment will support fetal cardiorespiratory physiology and will avoid the negative effects of air-based ventilation on the infant’s underdeveloped lungs.

Importantly, the PLS project will also address the major challenge in the development of the perinatal life support for the clinic, which is the clinical evaluation: Preclinical (animal) models are inadequate and clinical trials for the validation of such systems are not feasible for ethical reasons. The researchers aim to develop and validate the perinatal life support system using breakthrough simulation technology; herein, extremely premature infants and their birth are mimicked using a manikin, while advanced monitoring and computational modeling provide clinical guidance on fetal status and treatment.