Neonatal World Conference 2026

Abstract

Background:
Periventricular leukomalacia (PVL) is traditionally regarded as a neurologic complication of extreme prematurity. However, PVL is increasingly recognized in infants born at more advanced gestational ages, and their long-term neurodevelopmental outcomes remain insufficiently understood. To compare clinical characteristics and neurodevelopmental outcomes of infants with PVL according to gestational age at birth.

Methods:
This retrospective cohort study included preterm infants less than 37 weeks gestational age diagnosed with PVL in our hospital between January 2016 and December 2025. Infants were divided into two groups according to gestational age: <32 weeks and ≥32 weeks. Neonatal morbidities and long-term neurodevelopmental outcomes, including cerebral palsy (CP), were analyzed.

Results:
A total of 94 preterm infants with PVL were included, including 54 infants born at <32 weeks and 40 infants born at ≥32 weeks’ gestation. Infants born at <32 weeks demonstrated significantly higher rates of respiratory distress syndrome, hypotension, bronchopulmonary dysplasia, prolonged ventilator support, and longer hospitalization. However, despite lower systemic neonatal morbidity, infants born at ≥32 weeks continued to demonstrate a substantial burden of adverse neurodevelopmental outcomes. The prevalence of cerebral palsy remained high and comparable between groups (37 % versus 39.1%, respectively). Maternal inflammatory conditions, including chorioamnionitis, were observed in both groups.

Conclusions:
Although lower gestational age was associated with greater neonatal systemic morbidity, relatively advanced gestational age did not necessarily confer protection against adverse neurologic outcomes once PVL developed. Careful neurodevelopmental surveillance should therefore be considered even in moderate-to-late preterm infants with PVL.