Ex-Vivo Uterine Environment (EVE) Therapy Induced Limited Fetal Inflammation in a Premature Lamb Model

Preterm birth (live delivery prior to 37 weeks’ gestation) is responsible for at least 1 million perinatal deaths every year [1]. Despite significant advances in perinatal medicine (i.e. antenatal corticosteroid administration, surfactant therapy, advanced ventilation strategies), a significant proportion of infants born between 22 and 25 weeks’ gestation in high-resource settings will either die or experience life-long diseases of the cardiovascular, respiratory or neurosensory systems [2,3]. It is unclear if the high incidence of morbidity and mortality in this population is due to the antenatal exposures responsible for prematurity, or is as a result of forcibly adapting the highly immature physiology of a 22–25 week gestation fetus to pulmonary gas exchange in ex-uterine life. We have speculated that treating very premature babies without mechanical ventilation may allow them to be supported without causing or exacerbating injury. Designing treatment strategies that take advantage of the fetal-like physiology exhibited by extremely preterm infants may decrease morbidity and mortality of early preterm babies who cannot survive with existing neonatal intensive care. (Truncated)