Clinic Follow up and Neurological Disability in Children Following Pregnancies Complicated by Preterm Rupture of...

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Pediatric Neurology

Background:

• Preeclampsia and preterm premature rupture of membranes (PPROM) are known risk factors for perinatal brain injury.
• While links between preterm birth and neurologic deficits, and PPROM/preeclampsia and preterm birth are understood, the direct relationship between PPROM, preeclampsia, and subsequent neurologic disability is less clear.

Purpose of the Study:

• To compare trends in neurologic deficits in children born to mothers with preeclampsia or PPROM.
• To describe differences in patient characteristics, including follow-up visit attendance.

Main Methods:

• A prospective cohort study involving women diagnosed with preeclampsia or PPROM.
• Neurologic deficits were evaluated using the Pediatric Stroke Outcome Measure up to age 10.
• Eighty-nine of 178 enrolled women completed at least one follow-up assessment.

Main Results:

• In children born after 32 weeks gestation, PPROM was associated with significantly higher left and right-sided sensorimotor deficits at initial follow-up (p=0.045, p=0.01).
• For children born at or before 32 weeks, preeclampsia was linked to increased language production deficits at the 3-year follow-up (p=0.05).
• Sensorimotor deficits were more pronounced and persistent in the PPROM group, while language deficits were more prevalent after age 2 in the preeclampsia group. Racial disparities were observed in clinic attendance, disproportionately affecting Black families.

Conclusions:

• Distinct neurodevelopmental patterns suggest different underlying mechanisms of neuronal injury associated with PPROM and preeclampsia.
• Regular neurologic assessments throughout early childhood are recommended to identify delayed deficits and ensure equitable care for underserved populations affected by these conditions.