34 - Gestational age at birth predicts cerebellar development

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 34
Publication Number: 34.435

Rodolfo Cardenas Trejo, Children's National Health System, Washington, DC, United States; Abhya P. Vij, Boston Children's Hospital and Boston Medical Center, Boston, MA, United States; Adriana R. Valenzuela, Children's National Health Systems, Manassas Park, VA, United States; Javid Ghaemmaghami, Children's National Health System, Washington, D.C., DC, United States; Georgios Sanidas, School of Medicine, University of Patras, Athens, Attiki, Greece; Vittorio Gallo, Children's National Health System, Washington, DC, United States; Panagiotis Kratimenos, Children's National, Washington, DC, United States

Presenting Author(s)

Rodolfo Cardenas Trejo, MD (he/him/his)

Resident
Children's National Health System
Washington, District of Columbia, United States

Background:

Survivors of prematurity are at a fourfold increased risk for neuropsychiatric disorders, including ataxias and prediction learning deficits, compared to term-born infants. The cerebellum is significantly affected in preterm infants as it develops during the last trimester of pregnancy and early post-natal period, a timeframe that is compromised in this patient population.

Objective:

Here we test the hypothesis that gestational age at birth correlates with the cerebellar development at term equivalent age.

Design/Methods:

We used sonographic cerebellar measurements in a large cohort of preterm infants (n=624) when they reached term equivalent age and compared them with their term-born counterparts (n=402) matched for age and gender. Measurements were done manually on digital images using Synapse. Four diameter measurements were taken: midsagittal vermis vertical (VV), midsagittal anteroposterior diameter vermis (APDV), anteroposterior diameter coronal (APDC) and coronal transverse (CT). Linear regression was used to evaluate the relationship between matched term and preterm cerebellar diameters.

Results:

Compared to term, preterm infants lagged in cerebellar development displaying smaller cerebellar diameters at term equivalent age. Specifically, cerebella of preterm infants were smaller by an average of 2.04 cm in the VV (p< 0.001), 2.84 cm in the APDV (p< 0.001), 2.04 cm in the APDC (p< 0.001), and 6.69 cm in the CT (p< 0.001). This difference was more pronounced on severe prematurity (22-24 weeks gestation) in all four diameters. Secondary analysis showed that the cerebellar size at term-equivalent age correlated with gestational age at birth, with extremely premature infants demonstrating the slowest cerebellar development at term-equivalent age.

Conclusion(s):

These data indicate that gestational age at birth is a crucial driver of postnatal cerebellar development. Preterm neonates demonstrate compromised ex-utero cerebellar development and growth compared with their term born counterparts.