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Published on: November 20, 2015
Long-term neurodevelopmental outcomes at three years in preterm infants born before 29 Weeks gestation following
Harkirat Bhullar1,2, Amelie Stritzke1,2, Sue Makarchuk2
1Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Insights
Preterm premature rupture of membranes (PPROM) in infants born before 29 weeks gestational age (GA) was not linked to a higher risk of death or neurodevelopmental impairment (NDI) by 3 years corrected age (CA). This finding offers reassurance for this vulnerable infant population.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Developmental Pediatrics
Background:
- Preterm premature rupture of membranes (PPROM) is a significant concern in extremely preterm infants.
- Neurodevelopmental impairment (NDI) is a common outcome in infants born before 29 weeks gestational age (GA).
- The association between PPROM and long-term neurodevelopmental outcomes in this population requires further clarification.
Purpose of the Study:
- To investigate the relationship between PPROM and neurodevelopmental impairment (NDI) at 3 years corrected age (CA).
- To assess the risk of a composite outcome of death or NDI in infants born before 29 weeks GA based on maternal PPROM status.
Main Methods:
- A cohort study included infants born before 29 weeks GA between 2005 and 2017.
- The primary outcome was a composite of death or NDI (defined by IQ < 85, cerebral palsy, or sensory impairment) at 3 years CA.
- Multivariate models were used to analyze the association between maternal PPROM status and the primary outcome.
Main Results:
- The study included 1231 infants, with 481 in the PPROM group and 750 in the No PPROM group.
- After adjusting for confounding factors, the odds ratio for death or NDI in the PPROM group compared to the No PPROM group was 1.22 (95% CI: 0.93-1.59).
- This result indicates no statistically significant increase in the risk of the composite outcome associated with PPROM.
Conclusions:
- PPROM was not found to be associated with an increased risk of death or neurodevelopmental impairment at 3 years corrected age in infants born extremely preterm.
- These findings suggest that PPROM may not be a major determinant of adverse neurodevelopmental outcomes in this high-risk cohort.
- Further research may explore other factors influencing neurodevelopmental trajectories in infants exposed to PPROM.
Objective:
To determine the association between preterm premature rupture of membranes (PPROM) and neurodevelopmental impairment (NDI) at 3 years corrected age (CA) in infants born before 29 weeks of gestational age (GA).
Design/Methods:
Infants born before 29 weeks GA between 2005 and 2017 were included. The primary outcome was a composite of death or NDI (full-scale intelligence quotient<85, cerebral palsy, vision or hearing impairment) at 3 years of CA. Infants were stratified by maternal PPROM status. Associations were explored using multivariate models.
Results:
Of 1231 participants, 481 were in the PPROM group, and 750 were in the No PPROM group. After adjusting for factors, the odds ratio of death or NDI for PPROM vs. No PPROM was 1.22 (95% Confidence Interval 0.93-1.59).
Conclusion:
Our study suggests that PPROM was not associated with an increased risk of a composite outcome of death or NDI at 3 years CA.
