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Updated: Aug 8, 2026
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
The near-term (late preterm) human brain and risk for periventricular leukomalacia: a review
1Department of Pathology, Children's Hospital Boston and Harvard Medical School, MA 02115, USA. Hannah.kinney@childrens.harvard.edu
Insights
Periventricular leukomalacia (PVL), a brain injury common in premature infants, also affects late preterm and term infants. Understanding PVL in these infants is crucial for improving neurological outcomes.
Area of Science:
- Neonatal Neurology
- Neuroscience
- Developmental Neuroscience
Background:
- Historically, neonatal neurology research focused on very premature infants (<30 weeks gestation) due to poor neurological outcomes.
- Periventricular leukomalacia (PVL) is the primary cause of cerebral palsy in very premature infants.
- PVL and associated gray matter injury also occur in late preterm and term infants, but are less understood.
Purpose of the Study:
- To review the cellular pathology of PVL.
- To examine developmental parameters of oligodendrocytes and neurons that increase risk in the late preterm brain.
- To contextualize brain injury near term within broader brain development.
Main Methods:
- Literature review focusing on cellular pathology and developmental parameters.
- Analysis of neuroimaging and autopsy studies documenting PVL in late preterm and term infants.
- Discussion of brain development and injury mechanisms relevant to the near-term brain.
Main Results:
- PVL is not exclusive to very premature infants; it affects late preterm and term infants.
- Gray matter injury is linked to PVL in both very preterm and late preterm populations.
- Specific developmental vulnerabilities in the late preterm brain contribute to PVL risk.
Conclusions:
- The clinical and pathological aspects of brain injury, particularly PVL, in late preterm infants require further investigation.
- Optimizing management strategies for late preterm infants with PVL is essential.
- Adverse neurological outcomes in late preterm infants, though potentially subtle, may be underestimated and warrant more research.
Abstract:
Historically the major focus in neonatal neurology has been on brain injury in premature infants born less than 30 gestational weeks. This focus reflects the urgent need to improve the widely recognized poor neurological outcomes that occur in these infants. The most common underlying substrate of cerebral palsy in these premature infants is periventricular leukomalacia (PVL). Nevertheless, PVL also occurs in near-term (late preterm), as well as term, infants, as documented by neuroimaging and autopsy studies. In both very preterm and late preterm infants, gray matter injury is associated with PVL. In this review, we discuss the cellular pathology of PVL and the developmental parameters in oligodendrocytes and neurons that put the late preterm brain at risk in the broader context of brain development and injury close to term. Further research is needed about the clinical and pathologic aspects of brain injury in general and PVL in particular in late preterm infants to optimize management and prevent adverse neurological outcomes in these infants that, however subtle, may be currently underestimated.
