Preterm birth and disruptive cerebellar development: assessment of perinatal risk factors.
OBJECTIVE
Abnormal cerebellar development was recently recognized to be related to prematurity. Aim of the present study was to evaluate preterm birth and possible peri- and postnatal risk factors associated with this type of brain injury.


METHODS
We report on a series of 35 very low birth weight infants (birth weight 986+/-257g S.D.) born between 24 and 32 weeks of gestation (27.0+/-1.8 weeks of gestation S.D.) sustaining disruption of cerebellar development after preterm birth. Perinatal medical records of study patients were compared to 41 preterm control infants (birth weight 900+/-358g S.D., gestational age 26.3+/-2.1 weeks S.D.) with normal cerebellar development on MRI scan.


RESULTS
A severely compromised postnatal condition with consecutive intubation and catecholamine support was found to be significant risk factor. Additional supratentorial hemorrhagic brain injury followed by posthemorrhagic hydrocephalus, neurosurgical interventions and hemosiderin deposits on the cerebellar surface were significantly related to disruptive cerebellar development. No other differences in perinatal factors were found between the groups.


CONCLUSIONS
Premature birth between 24 and 32 gestational weeks associated with poor postnatal conditions and complicated supratentorial hemorrhagic brain lesions represents a high-risk situation for disruption of cerebellar development.
Messerschmidt
Agnes
A
Department of Neonatology and Pediatric Intensive Care, University Children's Hospital, Medical University of Vienna, Austria. agnes.messerschmidt@meduniwien.ac.at
Prayer
Daniela
D
Brugger
Peter C
PC
Boltshauser
Eugen
E
Zoder
Gerlinde
G
Sterniste
Walter
W
Pollak
Arnold
A
Weber
Michael
M
Birnbacher
Robert
R
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001034:Apgar Score; D015415:Biomarkers; D001724:Birth Weight / Q000502:physiology; D002526:Cerebellar Diseases / Q000151:congenital / Q000473:pathology; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000473:pathology; D003388:Cranial Fossa, Posterior / Q000378:metabolism; D005260:Female; D005865:Gestational Age; D006485:Hemosiderin / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D007752:Obstetric Labor, Premature; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012727:Sex Characteristics; D014463:Ultrasonography
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D006485:Hemosiderin