WASHINGTON (October 29, 2026) – A new study reveals that when a baby is born prematurely, their cerebellum, the part of the brain with a critical role in motor function, language and cognition, grows and develops in a different way than it would if the baby remains in utero full term.
The findings, published in Science , solve a long-standing medical puzzle: Why so many premature infants go on to face challenges with movement, language and learning in childhood, even though they have no detectable brain injuries. In short, the study overturns the decades-old view that premature birth slows down brain growth but that early arrivals “catch-up” by their original due date and beyond.
“We could always see the developmental differences that premature children faced, but we could not see the cellular machinery driving them,” says senior author Panagiotis Kratimentos, MD, PhD , a physician-scientist, neonatologist and director of Research and the Neonatal Neurocritical Care Program at Children’s National Hospital. “We now have a biological explanation thanks to a unique combination of data from both living participants and from existing brain tissue samples.”
Why it matters
Between 24 and 40 weeks of pregnancy, the human cerebellum undergoes its most rapid period of development, expanding fivefold in size as its primary neurons wire together into complex communication networks. This entire growth period happens inside the protective environment of the uterus for a full-term infant. When the baby is born prematurely, this rapid brain construction phase is forced to happen outside the womb.
“With this human cellular map in hand, we are moving into a new era of precision neurocritical care for premature newborns,” says Dr. Kratimenos. “Instead of treating the preterm brain as a black box, we can now design and time neuroprotective strategies to match the exact biological state of a baby’s brain cells in the NICU, helping them transition smoothly from early adaptation to healthy circuit-building.”
“Assessment and treatment of preterm infants should be guided by developmental maturity rather than chronological age,” said Vittorio Gallo, PhD, a joint senior author who began the research while at Children’s National. “The identified molecular markers will improve risk stratification, advance maturity biomarkers and optimize the timing of neuroprotective therapies.” Gallo continued the research collaboration after joining Seattle Children’s , where he now serves as senior vice president and chief scientific officer.
How the research was conducted
Study co-first authors Georgios Sanidas, MD, a physician-scientist, and Gabriele Simonti, a translational neuroscientist, from Children’s National’s Center for Neuroscience Research and Sheikh Zayed Institute for Pediatric Surgical Innovation , led the study. Drs. Sanidas and Simonti combined multiyear brain imaging and developmental tracking of 176 living infants with cellular analysis of pre-existing brain tissue from 83 preterm and term human infants. Samples came from tissue repositories, including the NIH NeuroBioBank, for spatial transcriptomics. This technology maps exact gene activity across intact tissue layers, revealing how major cerebellar neurons — Purkinje and granule cells — develop outside the womb compared with normal gestation.
“Studying human tissue alongside living patients allowed us to connect the molecular programs set at birth directly to how children grow and develop years later,” says Dr. Sanidas.
“By decoding these mechanisms directly in human datasets, we were able to see how the molecular programs governing Purkinje and granule cells respond not just to the timing of birth, but also to the clinical environment after birth,” adds Simonti. “We are now actively investigating targeted interventions based on these findings to steer the premature brain toward healthy maturation.”
This study was supported by the Raynor Cerebellum Project Foundation.
Media contact: Jennifer Stinebiser | jennifer.stinebiser@childrensnational.org | 202-476-4500
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About Children’s National
For 155 years, Children’s National in Washington, D.C., has delivered expert pediatric care at every milestone. As the region’s only standalone children’s hospital, kids have been the center of its mission since 1870. Today, it is one of the top 10 children’s hospitals in the nation and ranked in all specialties evaluated by U.S. News & World Report. Children’s National is transforming pediatric medicine for all children.
The Children’s National Research & Innovation Campus opened in 2021, a first-of-its-kind pediatric hub dedicated to developing new and better ways to care for kids. Children’s National has been designated four times in a row as a Magnet ® hospital, demonstrating the highest standards of nursing and patient care delivery. This pediatric academic health system offers expert care through a convenient, community-based primary care network and specialty care locations in the D.C. metropolitan area, including Maryland and Virginia. Children’s National is home to the Children’s National Research Institute and Sheikh Zayed Institute for Pediatric Surgical Innovation . It is recognized for its expertise and innovation in pediatric care and as a strong voice for children through advocacy at the local, regional and national levels.
In 1987, Children’s National founded Safe Kids Worldwide , a non-profit dedicated to reducing unintentional injuries among children through comprehensive national and global education, research and advocacy. As a non-profit, Children's National relies on generous donors to help ensure that every child receives the care they need.
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Intrinsic gestational timing governs human cerebellar development after preterm birth
29-Oct-2026