Perinatal Brain Injuries in Preterm Infants
- 1Department of Neonatology, Department for Gynecology and Obstetrics, University Hospital of Split, 21000 Split, Croatia
- 2Faculty of Health Sciences, University of Split, 21000 Split, Croatia
- 3School of Medicine, University of Split, 21000 Split, Croatia
Abstract
Background: Preterm infants are vulnerable to brain injury because of immature white matter, vascular regulation, and neuroprotective mechanisms. White matter injury (WMI), formerly known as periventricular leukomalacia, is a major cause of cerebral palsy and neurocognitive impairment, while perinatal stroke is an important cerebrovascular cause of adverse outcomes. White matter injury: WMI is linked to hypoxia–ischemia, inflammation or infection, oxidative stress, and impaired oligodendrocyte maturation. It may be cystic or diffuse non-cystic, which is now the most common phenotype. Cystic lesions are strongly associated with motor impairment and spastic cerebral palsy, whereas diffuse injury is increasingly related to cognitive, behavioral, and language deficits. Diagnosis relies on cranial ultrasonography and MRI; prevention focuses on optimized perinatal care, infection control, respiratory stabilization, and neuroprotection. Perinatal stroke: Stroke in preterm infants may occur antenatally or neonatally and includes periventricular hemorrhagic infarction, perinatal arterial ischemic stroke, and cerebral sinovenous thrombosis. Periventricular hemorrhagic infarction is the most common subtype and is often associated with germinal matrix hemorrhage–intraventricular hemorrhage. Risk factors are multifactorial, including fetal, neonatal, placental, thrombotic, infectious, and hemodynamic contributors. Clinical signs may be subtle, making neuroimaging central to classification and prognosis. Conclusion: Despite advances in neonatal care, WMI and perinatal stroke remain major causes of long-term neurological morbidity in preterm infants. Early recognition, systematic neuroimaging, risk stratification, and multidisciplinary follow-up are essential. Future research should identify reliable biomarkers and targeted neuroprotective therapies.
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BibTeX
@article{cherepnalkovski2026perinatal,
title = {{Perinatal Brain Injuries in Preterm Infants}},
author = {Anet Papazovska Cherepnalkovski and Luka Brajkovic and Klara Cogelja and Lovre Krsan Milostic and Nikolina Vidovic and Angela Renic and Duje Bulat and Jelena Sabljic and Ena Batinovic and Marija Bucat},
journal = {Cells},
year = {2026},
month = oct,
doi = {10.3390/cells15201905},
url = {https://www.mdpi.com/2073-4409/15/20/1905},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Perinatal Brain Injuries in Preterm Infants
AU - Anet Papazovska Cherepnalkovski
AU - Luka Brajkovic
AU - Klara Cogelja
AU - Lovre Krsan Milostic
AU - Nikolina Vidovic
AU - Angela Renic
AU - Duje Bulat
AU - Jelena Sabljic
AU - Ena Batinovic
AU - Marija Bucat
PY - 2026
DA - 2026/10/20
JO - Cells
DO - 10.3390/cells15201905
UR - https://www.mdpi.com/2073-4409/15/20/1905
AB - Background: Preterm infants are vulnerable to brain injury because of immature white matter, vascular regulation, and neuroprotective mechanisms. White matter injury (WMI), formerly known as periventricular leukomalacia, is a major cause of cerebral palsy and neurocognitive impairment, while perinatal stroke is an important cerebrovascular cause of adverse outcomes. White matter injury: WMI is linked to hypoxia–ischemia, inflammation or infection, oxidative stress, and impaired oligodendrocyte maturation. It may be cystic or diffuse non-cystic, which is now the most common phenotype. Cystic lesions are strongly associated with motor impairment and spastic cerebral palsy, whereas diffuse injury is increasingly related to cognitive, behavioral, and language deficits. Diagnosis relies on cranial ultrasonography and MRI; prevention focuses on optimized perinatal care, infection control, respiratory stabilization, and neuroprotection. Perinatal stroke: Stroke in preterm infants may occur antenatally or neonatally and includes periventricular hemorrhagic infarction, perinatal arterial ischemic stroke, and cerebral sinovenous thrombosis. Periventricular hemorrhagic infarction is the most common subtype and is often associated with germinal matrix hemorrhage–intraventricular hemorrhage. Risk factors are multifactorial, including fetal, neonatal, placental, thrombotic, infectious, and hemodynamic contributors. Clinical signs may be subtle, making neuroimaging central to classification and prognosis. Conclusion: Despite advances in neonatal care, WMI and perinatal stroke remain major causes of long-term neurological morbidity in preterm infants. Early recognition, systematic neuroimaging, risk stratification, and multidisciplinary follow-up are essential. Future research should identify reliable biomarkers and targeted neuroprotective therapies.
SN - 2073-4409
ER -