title: Behavioural and neurodevelopmental outcome of 2-year-old children after preterm premature rupture of membranes: follow-up of a randomised clinical trial comparing induction of labour and expectant management.
abstract: OBJECTIVE
  We recently reported that induction of labour does not improve short term neonatal outcome in women with late preterm premature rupture of membranes (PPROM) as compared to expectant management (PPROMEXIL trial). In this study the neurodevelopmental and behavioural outcome of the children from this trial at 2 years of age was studied.
  
  
  METHODS
  We studied outcome of offspring of women randomised in the PPROMEXIL study. These women had >24h of ruptured membranes and were between 34 and 37 weeks of pregnancy when they were randomised to induction of labour (IoL) or expectant management (EM). Two years after delivery, the parents received the ages and stages questionnaire (ASQ), the child behaviour checklist (CBCL) and a general questionnaire.
  
  
  RESULTS
  Follow-up data were obtained from 234 children (121 after IoL, 113 after EM, response rate 59% (44% of the original 532 randomised women)). In the IoL group 16 children (14%) had an abnormal score in ≥1 domains of the ASQ, versus 27 (26%) in the EM group (difference in percentage -11.4 (95% CI -21.9 to -0.98; p=0.033)). For the CBCL, an abnormal score was found in 13% (n=15) in the IoL group and in 15% (n=16) in the EM group (difference in percentage -2.13 (95% CI -11.2 to 6.94; p=0.645)).
  
  
  CONCLUSIONS
  Although a policy of induction of labour in women with late PPROM does not improve short term neonatal outcome, it might be associated with a decrease in neurodevelopmental difficulties at the age of two years as compared to expectant management. Expectant management did not lead to a difference in behavioural problems.
authors: Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands. Electronic address: jvdheijden84@hotmail.com.
authors: Jantien L
authors: JL
authors: van der Heyden
authors: Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands.
authors: Christine
authors: C
authors: Willekes
authors: Utrecht University, Utrecht, The Netherlands.
authors: Anneloes L
authors: AL
authors: van Baar
authors: Academic Medical Centre, Amsterdam, The Netherlands.
authors: Aleid G
authors: AG
authors: van Wassenaer-Leemhuis
authors: Academic Medical Centre, Amsterdam, The Netherlands.
authors: Eva
authors: E
authors: Pajkrt
authors: University Medical Centre Utrecht, Utrecht, The Netherlands.
authors: Martijn A
authors: MA
authors: Oudijk
authors: Máxima Medical Centre, Veldhoven, The Netherlands.
authors: Martina M
authors: MM
authors: Porath
authors: Erasmus Medical Centre, Rotterdam, The Netherlands.
authors: Hans J J
authors: HJ
authors: Duvekot
authors: Leids University Medical Centre, Leiden, The Netherlands.
authors: Kitty W M
authors: KW
authors: Bloemenkamp
authors: University Medical Centre Groningen, Groningen, The Netherlands.
authors: Mariette
authors: M
authors: Groenewout
authors: University Medical Centre St. Radboud, Nijmegen, The Netherlands.
authors: Mallory
authors: M
authors: Woiski
authors: Isala, Zwolle, The Netherlands.
authors: Bas
authors: B
authors: Nij Bijvank
authors: VU Medical Centre, Amsterdam, The Netherlands.
authors: Caroline J
authors: CJ
authors: Bax
authors: Academic Medical Centre, Amsterdam, The Netherlands.
authors: Janneke
authors: J
authors: van 't Hooft
authors: Ziekenhuisgroep Twente, Almelo, The Netherlands.
authors: Marko J M
authors: MJ
authors: Sikkema
authors: Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors: Bettina M C
authors: BM
authors: Akerboom
authors: Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands.
authors: Twan A L M
authors: TA
authors: Mulder
authors: Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands.
authors: Jan G
authors: JG
authors: Nijhuis
authors: Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia.
authors: Ben Willem J
authors: BW
authors: Mol
authors: Martini Hospital, Groningen, The Netherlands.
authors: David P
authors: DP
authors: van der Ham
mesh_terms: D000328:Adult; D002652:Child Behavior; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005500:Follow-Up Studies; D006801:Humans; D007751:Labor, Induced; D011247:Pregnancy
keywords: Behavioural outcome; Developmental outcome; Follow-up; Preterm prelabor rupture of membranes