Limperopoulos C et al. (2007) Does cerebellar injury in premature infants contribute to the high prevalence of long-term cognitive, learning, and behavioural disability in survivors. Pediatrics 120: 584–593

Cerebellar hemorrhagic injury (CHI) is increasingly recognized as a complication of premature birth; however, few studies have examined its potential role in the high prevalence of cognitive, learning and behavioral disabilities observed in premature infants. To evaluate the possible effect of CHI on neurodevelopment in ex-preterm infants, Limperopoulos et al. conducted a retrospective case–control study.

The researchers identified 51 premature infants with CHI (16 with additional supratentorial parenchymal injury) from their neonatal cranial ultrasonography records, and matched each isolated CHI case with a control infant from previous prospective studies.

Neurologic abnormalities were detected in 66% of infants with CHI compared with only 5% of control infants. In comparison with control infants, those with isolated CHI had lower mean scores for gross and fine motor functioning, expressive and receptive language and visual reception (Mullen Scales of Early Learning; P <0.001 for all), and lower scores for communication, daily living, socialization and motor functioning (Vineland Adaptive Behavior Scale; P <0.001 for all). The prevalence of neurodevelopmental abnormalities was no higher in infants with CHI and supratentorial parenchymal injury than in those with isolated CHI, although neuromotor impairment was more severe. In addition, infants with CHI had a greater prevalence of positive screening tests for autism as well as for internalizing behavioral problems. The authors conclude that CHI in premature infants is associated with an increased risk of neurodevelopmental abnormalities, a fact that is currently under-recognized.