title: Cognitive impairment at age 5 years in very preterm infants born following premature rupture of membranes.
abstract: OBJECTIVE
  To evaluate the relationship between preterm premature rupture of membranes (PPROM) and cognitive impairment in 5-year-old children born very preterm.
  
  
  METHODS
  The Etude Epidémiologique sur les Petits Ages Gestationnels Study is a population-based cohort of children followed up from birth to age 5 years recruited in 9 French regions in 1997. We analyzed data from singletons born between 24 and 32 weeks gestation categorized into 4 groups according to etiology of prematurity: infants born after PPROM, after idiopathic preterm labor, in a vascular context (Vasc), and to women with other complications (Other). Cognitive development at age 5 years was assessed using the Mental Processing Composite score of the Kaufman-Assessment Battery for Children.
  
  
  RESULTS
  Among the 1051 children followed up to age 5 years, the mean Mental Processing Composite score was 93.6 ± 19.7, and 13.3% of the children (140 of 1051) had cognitive impairment. After adjustment for potential confounders, the risk of cognitive impairment among infants in the PPROM group was not significantly different than that in the idiopathic preterm labor group (OR, 1.09; 95% CI, 0.62-1.92) and the Other group (OR, 1.36; 95% CI, 0.75-2.47), but was lower than that in the Vasc group (OR, 1.86; 95% CI, 1.16-2.97). In the PPROM group, the risk of cognitive impairment was greater when the latency period (ie, time from rupture to delivery) was <3 days (OR, 2.32; 95% CI, 1.07-5.02).
  
  
  CONCLUSIONS
  Preterm infants born after PPROM are not at increased risk for cognitive impairment in childhood, but the time between PPROM and birth may influence that risk.
authors.affiliation: Clinical Investigation Center and Information Medical Department, University Hospital of Montpellier, Montpellier, France. t-mura@chu-montpellier.fr
authors.forename: Thibault
authors.initials: T
authors.lastname: Mura
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Picaud
authors.forename: Béatrice
authors.initials: B
authors.lastname: Larroque
authors.forename: Florence
authors.initials: F
authors.lastname: Galtier
authors.forename: Stephane
authors.initials: S
authors.lastname: Marret
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Roze
authors.forename: Patrick
authors.initials: P
authors.lastname: Truffert
authors.forename: Pierre
authors.initials: P
authors.lastname: Kuhn
authors.forename: Jeanne
authors.initials: J
authors.lastname: Fresson
authors.forename: Gérard
authors.initials: G
authors.lastname: Thiriez
authors.forename: Catherine
authors.initials: C
authors.lastname: Arnaud
authors.forename: Gregoire
authors.initials: G
authors.lastname: Mercier
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Picot
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Ancel
authors.forename: Bernard
authors.initials: B
authors.lastname: Ledesert
mesh_terms: D002675:Child, Preschool; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies
keywords: EPIPAGE; Etude Epidémiologique sur les Petits Ages Gestationnels; IPL; Idiopathic preterm labor; K-ABC; Kaufman Assessment Battery for Children; MPC; Mental Processing Composite; PPROM; Preterm premature rupture of membranes; SGA; Small for gestational age; Vasc; Vascular