Preterm Birth and Disruptive Cerebellar Development: Assessment of Perinatal Risk Factors

Objective: Cerebellar injury is increasingly recognized as a prematurity-related brain lesion. Whereas the morphological characteristics have already been described, preterm birth and its risk factors for the cerebellar development remain to be evaluated.

Patients and Methods: We report on a series of 35 very low birth weight infants (mean birth weight 986g) born between 24 and 32 gestational weeks (mean gestational age 27 weeks) sustaining disruption of cerebellar development as a consequence of extreme prematurity. Perinatal medical records of affected patients were compared to an appropriate control group of 41 preterm infants (mean birth weight 900g, mean gestational age 26,3 weeks) with normal cerebellar development.

Results: Absence of antenatal glucocorticoid therapy, low APGAR scores at minute 1, occurrence of hyaline membrane disease, early postnatal intubation and catecholamine support were found to be significant risk factors. Furthermore, intraventricular hemorrhage, white matter loss, posthemorrhagic hydrocephalus, neurosurgical interventions and hemosiderin deposits in the posterior fossa were significantly associated with disruptive cerebellar development. No other differences in perinatal factors were found between the groups.

Conclusion: Premature birth between 24–32 gestational weeks together with poor postnatal presentation and complicated cerebral injury represents a high risk situation for disruption of cerebellar development.

Key Words: cerebellum, disruptive development, prematurity, brain injury, hemosiderin