Buchmayer Julia, Fuiko Renate, Kienast Patric, Stummer Sophie, Kasprian Gregor, Berger Angelika, Goeral Katharina
Comprehensive Center for Pediatrics, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria.
Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.
Dev Med Child Neurol. 2025 May;67(5):609-617. doi: 10.1111/dmcn.16123. Epub 2024 Oct 20.
To investigate the impact of cerebellar haemorrhage (CBH) and atrophy in infants born extremely preterm with intraventricular haemorrhage (IVH) on neurodevelopment at 2 years of age.
This retrospective case-control study included infants born at less than 28 weeks' gestation with IVH over a 10-year period. CBH, along with the assessment of cerebellar size, using magnetic resonance imaging, were studied. The impact of injuries on neurodevelopmental outcome at 2 years' corrected age was conducted, using multivariable regression analysis for comprehensive evaluation.
In a cohort of 103 patients, 69 (67.0%) showed CBH with a median grade of 1 (interquartile range = 0-3). At the corrected age of 2 years, CBH was significantly associated with impaired cognitive and motor outcome. CBH emerged as an independent predictor of poor cognitive and motor development, as well as cerebral palsy. Cerebellar atrophy, affecting 30 (29.1%) infants, was linked to a significantly worse outcome across all domains. Conversely, an increase in cerebellar size was correlated with improved motor development.
Infants born extremely preterm with IVH and concomitant CBH exhibited significant cognitive and motor impairment. The severity of developmental delay correlated with the grade of CBH. These findings hold potential to support the prediction of long-term outcome and parental counselling.
探讨极早产儿脑室内出血（IVH）合并小脑出血（CBH）及萎缩对其2岁时神经发育的影响。
这项回顾性病例对照研究纳入了10年间孕周小于28周且患有IVH的婴儿。采用磁共振成像研究了CBH以及小脑大小评估情况。使用多变量回归分析进行综合评估，以确定损伤对2岁矫正年龄时神经发育结局的影响。
在103例患者队列中，69例（67.0%）出现CBH，中位分级为1级（四分位间距=0-3）。在2岁矫正年龄时，CBH与认知和运动结局受损显著相关。CBH是认知和运动发育不良以及脑瘫的独立预测因素。30例（29.1%）婴儿出现小脑萎缩，与所有领域的结局显著较差相关。相反，小脑大小增加与运动发育改善相关。
极早产儿IVH合并CBH表现出显著的认知和运动障碍。发育迟缓的严重程度与CBH分级相关。这些发现可能有助于支持长期结局的预测和家长咨询。
