Related Experiment Video
Updated: Aug 24, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Fetal growth and infant neurodevelopmental outcome after preterm premature rupture of membranes
Arsenio Spinillo1, Laura Montanari, Patrizia Sanpaolo
1Department of Obstetrics and Gynecology, University of Pavia, IRCCS Policlinico S. Matteo, Piazzale Golgi, 27100 Pavia, Italy. spinillo@smatteo.pv.it
Insights
Fetal size and growth during preterm premature rupture of membranes (PROM) impact infant neurodevelopment. Lower-than-expected measurements predict a higher risk of neurodevelopmental abnormalities at 2 years.
Area of Science:
- Perinatology
- Neonatal Neurology
- Fetal Medicine
Background:
- Preterm premature rupture of membranes (PROM) presents significant risks to fetal development and long-term infant outcomes.
- Assessing fetal size and growth during the latency period of PROM is crucial for predicting neonatal complications and neurodevelopmental trajectories.
Purpose of the Study:
- To investigate the prognostic significance of fetal size before birth and fetal growth during the latency period in pregnancies complicated by preterm PROM.
- To correlate these fetal measurements with short-term neonatal complications and 2-year infant neurodevelopmental outcomes.
Main Methods:
- Prospective cohort study of 69 singleton pregnancies with prolonged PROM (≥14 days) between 24-31 weeks gestation.
- Fetal size and growth measures were compared to reference curves; associations with neonatal complications and 2-year neurodevelopmental outcomes were analyzed using univariate and logistic regression.
Main Results:
- Lower-than-expected fetal birth weight, head circumference, and abdominal circumference growth during the latency period were observed in infants who died or had cerebral palsy compared to healthy survivors.
- Logistic regression identified lower-than-expected fetal abdominal circumference before birth (OR 1.09) and during latency (OR 1.1) as significant predictors of neurodevelopmental abnormality at 2 years.
Conclusions:
- In preterm PROM pregnancies, reduced fetal size and growth are associated with adverse neurodevelopmental outcomes at 2-year follow-up.
- Ultrasound-derived fetal measurements during the latency period can serve as valuable prognostic indicators for neurodevelopmental abnormalities.
Objective:
To evaluate the prognostic values of fetal size before birth and fetal growth during the latency period in patients with preterm premature rupture of the membranes (PROM).
Methods:
A prospective cohort study of 69 singleton pregnancies complicated by prolonged (14 days or more) PROM (24 to 31 weeks of gestation). Measures of fetal size and growth were compared with corresponding expected values from our reference curves. The correlations between deviations from expected measures of fetal size and growth, short-term neonatal complications, and infant neurodevelopmental outcome at 2 years were studied by univariate methods and logistic regression.
Results:
The mean gestational ages and standard deviations at membrane rupture and at birth were 27.9 +/- 2.4 and 31.5 +/- 2.1 weeks. At a corrected age of 2 years, of the 65 (94.2%) survivors, 3 infants (4.6%) had cerebral palsy, 13 (20%) had minor neurodevelopmental impairment, and 49 (75.4%) were judged to have had normal development. Compared with surviving infants without a major handicap, the group of infants who died and those with cerebral palsy had lower proportions of expected birth weight (0.766 +/- 0.1 as compared with 0.859 +/- 0.13, P =.029), head (0.869 +/- 0.07 as compared with 0.950 +/- 0.07, P =.05), and abdominal (0.793 +/- 0.04 as compared with 0.888 +/- 0.1, P =.001) circumference growth during latency period. In logistic regression analysis, lower-than-expected ultrasound measures of fetal abdominal circumference before birth (odds ratio 1.09; 95% confidence interval 1.01, 1.18) or of abdominal circumference growth during the latency period (odds ratio 1.1; 95% confidence interval 1.01, 1.2) were significantly associated with an increased likelihood of an infant neurodevelopmental abnormality at 2-year follow-up.
Conclusion:
In pregnancies complicated by preterm PROM, lower-than-expected measures of fetal size and fetal growth were associated with an increased rate of infant neurodevelopmental outcome at 2-year follow-up.
Level Of Evidence:
II-2
Related Concept Videos
01:07Teratogenicity
01:30Neurulation