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[Cerebellar injury in premature infants less than 30 weeks of gestation]
1Service de réanimation et pédiatrie néonatales (Pr Y. Aujard), hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, université Paris 7 Denis-Diderot, 48, boulevard Sérurier, 75019 Paris, France. valerie.biran@rdb.aphp.fr
Insights
Cerebellar injury occurs in 9% of very preterm infants and is linked to developmental deficits. Early neurobehavioral follow-up is crucial for these infants.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Neonatology
Context:
- The cerebellum, traditionally viewed as a motor control center, is increasingly recognized for its role in cognitive and social development.
- Very preterm infants are vulnerable to brain injury, including the cerebellum, which can impact long-term neurodevelopmental outcomes.
Purpose:
- To determine the incidence of cerebellar injury in very preterm infants.
- To identify obstetrical, neonatal, and radiological factors associated with cerebellar injury.
- To evaluate the functional outcomes of very preterm infants with cerebellar injury.
Summary:
- This retrospective study analyzed 148 very preterm infants (born <30 weeks gestational age). Cerebellar injury was identified in 9% of cases, often co-occurring with supratentorial injury (90%). Infants with cerebellar injury required longer ventilation durations.
- Global developmental, functional, and social-behavioral deficits were more prevalent in preterm infants with cerebellar injury compared to controls.
Impact:
- This research highlights the significant incidence of cerebellar injury in very preterm neonates.
- Findings underscore the necessity for targeted neurobehavioral follow-up assessments in this vulnerable population to mitigate long-term deficits.
Unlabelled:
Traditionally, the cerebellum has been regarded as a central component of the motor system. Recent studies suggest an important role played by the cerebellum in the development of cognitive and social functions. The objective of this study was to evaluate the incidence of cerebellar injury and to define the obstetrical, neonatal, and radiologic characteristics, as well as the functional outcomes in a population of very preterm infants.
Methods:
This retrospective study included neonates born before 30 weeks of gestational age between March 2004 and July 2007. Infants underwent MRI studies at a term-adjusted age; for each preterm infant with cerebellar injury, we identified two infants for the control group with normal MRI, matched on the basis of gestational age. We collected pertinent demographic, prenatal, and acute postnatal data for all infants. Follow-up assessment was performed at 2 years, using the Brunet-Lezine scale.
Results:
A total of 148 ex-preterm infants were studied. Cerebellar injury was present in 14 (9 %) cases and associated with supratentorial parenchymal injury in 90 %. Duration of ventilation was longer in children with cerebellar injury, compared to controls (19.5 days vs 16.5 days; P=0.03). The other neonatal criteria analyzed were comparable between the two groups. Global developmental, functional, and social-behavioral deficits were more common and profound in preterm infants with cerebellar injury, with no significant difference.
Conclusion:
This study confirms the high incidence of cerebellar injury in very preterm infants and the importance of a specific neurobehavioral follow-up.
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