Associations Between Neonatal Brain Structure and Neurodevelopmental Outcomes Following Very Preterm Birth

Background Very preterm (VPT) children have high risks of neurodevelopmental delays, yet early predictors for specific impairments are poorly understood. This study investigated how neonatal brain structure relates to neurodevelopmental delays in VPT toddlers. Methods We analyzed T2-weighted MRI scans at term from 352 VPT children. Neurodevelopmental outcomes were assessed at 18–24 months using the Bayley Scales of Infant and Toddler Development-III. We used tensor-based morphometry to compare voxel-wise whole-brain volumes between delayed and non-delayed groups. Results Toddlers with motor delays showed significantly reduced volume in the left posterior cerebellum at term compared to those without, even after accounting for other delays. No significant volumetric differences were found for cognitive or language delays. Conclusion Reduced cerebellar volume at term may indicate motor delay in VPT children. These findings highlight the cerebellum's crucial role in early motor development and the value of structural MRI for early risk stratification.