Two-year neonatal outcome following PPROM prior to 25 weeks with a prolonged period of oligohydramnios.
BACKGROUND
Improved neonatal survival data have been reported following early preterm prelabour rupture of membranes (PPROM) prior to 25 weeks gestation with a prolonged latency to delivery and persistent oligohydramnios. However, data regarding long-term respiratory and neurological morbidity are lacking.


OBJECTIVE
To evaluate the respiratory and neurological outcome data at two years of age in a cohort of infants born following PPROM prior to 25 weeks with a prolonged latency (14 days) to delivery and compare the data to an aged matched group of infants.


METHODS
Retrospective case note analysis over a 43-month period at Saint Luc University Hospital, Brussels.


RESULTS
15 surviving infants born following PPROM were matched to a group of 30 control infants. Although there was no significant difference in the incidence of BPD between the groups (33% vs 27%, p=0.24), the length of hospitalisation, duration of respiratory support and number of hospital readmissions for respiratory indications were all significantly higher for infants born following a prolonged period of oligohydramnios. There were no major anomalies on cranial ultrasound in the PPROM group and Baileys developmental assessment at 20-24 months corrected gestational age showed no difference between the two groups (Mental development index 93.9 vs 94.4 and Psychomotor development index 95.5 vs 95.8 respectively p = ns).


CONCLUSIONS
Neurodevelopmental outcome appears encouraging in this cohort although these infants are at high risk of prolonged initial hospitalisation and significant respiratory morbidity in the first two-years of life.
Department of Neonatology, Cliniques Universitaires Saint Luc, Catholic University of Louvain, 10 Avenue Hippocrate, Brussels, Belgium. olivia.williams@uclouvain.be
O
O
Williams
B
B
Michel
G
G
Hutchings
C
C
Debauche
C
C
Hubinont
D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D009017:Morbidity; D016104:Oligohydramnios / Q000453:epidemiology*; D011247:Pregnancy