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

Jantien L. Van Der Heyden, Christine Willekes, Anneloes L. Van Baar, Aleid G. Van Wassenaer-Leemhuis, Eva Pajkrt, Martijn A. Oudijk, Martina M. Porath, Hans J. Duvekot, Kitty W M Bloemenkamp, Mariette Groenewout, Mallory Woiski, Bas Nij Bijvank, Caroline J. Bax, Janneke Van 'T Hooft, Marko M. Sikkema, Bettina M C Akerboom, Twan L M Mulder, Jan G. Nijhuis, Ben Willem J Mol, David P. Van Der Ham

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6 Citations (Scopus)

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. Study design We studied outcome of offspring of women randomised in the PPROMEXIL study. These women had >24 h 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)). Conclusion 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.

Original languageEnglish
Pages (from-to)17-23
Number of pages7
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume194
DOIs
Publication statusPublished - Nov 2015

Keywords

  • Behavioural outcome
  • Developmental outcome
  • Follow-up
  • Preterm prelabor rupture of membranes

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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