A recent study described the early neurodevelopmental outcomes following fetal exposure to pre-viable preterm prelabour rupture of membranes (pPPROM). This secondary analysis of a subgroup of neonates born followed pPPROM from a retrospective cohort study. It included surviving infants who underwent standardized neurodevelopmental evaluation at 18–24 months corrected age (CA). 

It linked the Data abstracted from hospital charts to prospectively collected developmental outcomes stored in an electronic database from a regional neonatal follow-up clinic. 

The study looked for Bayley-III composite scores and the presence of cerebral palsy, vision loss, hearing impairment, and the requirement for rehabilitation therapy. The study found that 25.7% of neonates born after pPPROM survived hospital discharge, but only 21.6% survived to 18–24 months CA. Among these, nine infants were eligible for follow-up at the regional clinic, and seven had developmental outcomes stored in the electronic database. Infants exposed to pPPROM had Bayley-III scores more than 1 SD below the population mean across all three domains: cognitive, motor, and language. There were separate deficiencies in language development, with 71% scoring more than 2 SDs below the population mean. Furthermore, there were no cases of cerebral palsy. 

This study shows that only 1 in 5 infants born following expectantly managed pPPROM survive to 18–24 months CA. Infants born after pPPROM have significantly lower Bayley-III scores and particular deficiencies in language development. Understanding early neurodevelopmental challenges following pPPROM will help refine the counseling of families contemplating expectant management and provide insights into the postnatal educational resources required to improve long-term developmental outcomes for these children.

Pylypjuk CL, Nikel K, Day C, et al. Early Neurodevelopmental Outcomes after Previable Preterm Prelabour Rupture of Membranes (pPPROM). Case Reports in Pediatrics.2022;2022. https://doi.org/10.1155/2022/3428841