Abstract 389: Gestational Inflammation and Perinatal Arterial Ischemic Stroke: A Causal Connection?
Bibliographic record
Abstract
Introduction: Perinatal arterial ischemic strokes affect about 1/3,000 newborn and are the main cause of hemiplegic cerebral palsy. The large cerebral arteries from the anterior system, namely the intra-cranial carotid bifurcation, are the most affected, ischemic stroke being located in its territory in 85% of cases. The classic, but unproven, pathophysiological hypothesis postulated that arterial occlusion was caused by emboli from placental origin. This remains controversial due to the major unbalance of brain infarcts between anterior and posterior distribution, and to the absence of associated extra-cerebral infarcts. A new pathophysiological perspective emerged from the epidemiological association between gestational inflammation and perinatal stroke. Our hypothesis is that materno-foetal inflammation, induced by gestational exposure to pathogens, leads to a site-specific vasculitis affecting the carotid bifurcation and then triggering a focal thrombosis. Material and methods: Dams were injected with saline or lipopolysaccharide (LPS) from Escherichia coli (200 μg/kg/12h) between gestational day (G) 21 and 22. Brains were harvested at G21, G22 and postnatal day 1 (P1). At P1, a prothrombotic stress (transcutaneous photothrombosis) was applied on middle cerebral arteries to compare its susceptibility to thrombosis between LPS-exposed or unexposed pups. Immunohistochemistry and ELISA detected maternal, placental and fetal/neonatal inflammatory markers. Results: Our results showed a maternal, placental and fetal inflammation mediated by IL-1β, TNF-α and MCP-1 as well as an arterial inflammation in relation with the clinical pattern of perinatal arterial ischemic strokes. LPS+photothrombosis pups presented ischemic strokes and motor impairments, which were not detected when photothrombosis was applied without prior treatment with LPS. Conclusion: Preliminary results from our new pre-clinical model support our hypothesis of increased susceptibility of anterior cerebral arteries to gestational inflammation, and open a new vasculitic pathophysiological avenue to understand perinatal stroke.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".