title: Neonatal and two-year outcomes after rupture of membranes before 25 weeks of gestation.
abstract: OBJECTIVE
  To assess the impact of extreme preterm premature rupture of membranes (PPROM) <25 weeks of gestation on preterm child outcome.
  
  
  METHODS
  Retrospective study comparing the neonatal and 2-year outcomes of infants exposed to extremely PPROM <25 weeks with a non-exposed group of neonates in a tertiary care referral centre located in Paris, France, between 2003 and 2007. All women with singleton pregnancy and PPROM between 15(0/7) and 24(6/7) weeks of gestation were recruited. For each infant born alive, the next inborn neonate matched for gestational age and sex was selected as a control among neonates born alive after spontaneous preterm labour with intact membranes. The main outcome measures were neonatal outcome assessed by a combined criterion of adverse neonatal outcomes and the two-year neurodevelopmental outcome assessed by developmental Brunet-Lézine tests and neurological examinations.
  
  
  RESULTS
  In 78 cases of extremely PPROM, 22 live births occurred at a mean gestational age of 26(5/7) weeks. The percentage of neonates with adverse neonatal outcomes was significantly higher among PPROM than non-exposed cases (68.2 versus 27.3%). At 2 years of age, children from the PPROM group were more likely to have delayed acquisitions (64.3 versus 15.8%) and behavioural disorders (57.1 versus 15.8%). Mean Brunet-Lézine language score was significantly lower among those infants (78.9 versus 96.8).
  
  
  CONCLUSIONS
  PPROM <25 weeks is associated with increased neonatal mortality and morbidity and with increased risks of delayed acquisitions, behavioural disorders and lower language performance scores at 2 years in comparison with matched preterm neonates born after spontaneous preterm labour with intact membranes.
authors.affiliation: Neonatal Intensive Care Unit, Groupe Hospitalier Cochin Port Royal Saint Vincent de Paul, APHP, Université Paris Descartes, Paris, France.
authors.forename: Juliana
authors.initials: J
authors.lastname: Patkai
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmitz
authors.forename: Olivia
authors.initials: O
authors.lastname: Anselem
authors.forename: Siham
authors.initials: S
authors.lastname: Mokbat
authors.forename: Pierre-Henri
authors.initials: PH
authors.lastname: Jarreau
authors.forename: François
authors.initials: F
authors.lastname: Goffinet
authors.forename: Elie
authors.initials: E
authors.lastname: Azria
mesh_terms: D000328:Adult; D002657:Child Development; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007804:Language Development; D007805:Language Development Disorders / Q000453:epidemiology; D010297:Paris / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult