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Early-Life Clinical Factors Shape Cerebellar Structure in Preterm-Born Children

Victoria Rapos1,2, Steven Ufkes1,2, Cecil Chau1,2

  • 1Department of Pediatrics University of British Columbia Vancouver British Columbia Canada.

Annals of the Child Neurology Society
|August 7, 2026
PubMed

Insights

Neonatal illness and procedures in very preterm infants are linked to smaller cerebellar volumes and reduced brain connectivity. These factors negatively impact motor and cognitive functions at school age.

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Pediatric Neurology

Background:

  • Preterm birth significantly impacts brain development, with neonatal factors like illness and interventions posing risks.
  • While neonatal brain injury effects are studied, the link between cerebellar maturation and later motor/cognitive function in preterm children needs further clarification.

Purpose of the Study:

  • To investigate the association between neonatal clinical factors and specific cerebellar volumes and white matter pathways at 8 years of age.
  • To explore how cerebellar development in very preterm children relates to school-age motor and cognitive outcomes.

Main Methods:

  • Neuroimaging, clinical, and behavioral data from 130 very preterm infants (24-32 weeks GA) were analyzed.
  • Cerebellar subregions were segmented using CerebNet, and white matter connectivity was assessed via tractography.
  • Statistical analyses examined relationships between neonatal factors, cerebellar structure/connectivity, and neurodevelopmental outcomes.

Main Results:

  • Mechanical ventilation, invasive procedures, and opioid exposure correlated with reduced cerebellar volumes in specific regions.
  • Higher neonatal mortality risk (SNAPPE-II) was associated with decreased cerebellar connectivity at 8 years.
  • Smaller cerebellar volumes and impaired connectivity were linked to poorer cognitive and motor performance.

Conclusions:

  • Neonatal illness severity and exposures (procedures, opioids) in very preterm infants are associated with altered cerebellar development.
  • These cerebellar changes correlate with deficits in cognitive and motor functions observed at 8 years of age.
Abstract

Keywords:
cerebellumneurodevelopmentpreterm‐born children

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