509 - Long-Term Neurodevelopmental Outcomes at 3 Years in Preterm Infants Born at <29 Weeks Gestational Age Following Preterm Premature Rupture of Membranes

Poster Number: 509
Publication Number: 509.1361

Background: Approximately one-third of preterm births are complicated by preterm premature rupture of membranes (PPROM) and result in significant neonatal morbidity and mortality. However, it is unclear how it affects long-term neurodevelopmental outcomes at 3 years of corrected age (CA).

Objective: To determine the association between preterm premature rupture of membranes and neurodevelopmental impairment (NDI) at 3 years CA in infants born before 29 weeks of gestational age.

Design/Methods: Infants born before 29 weeks GA between 2005-2017 and evaluated at the neonatal follow-up clinic at 3 years CA were included. Demographic characteristics were collected, and neurodevelopmental status were assessed based on abnormal muscle tone, hearing and vision assessments, and cognitive delay on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III or IV), and compared using univariate and multivariable regression models. Two groups were identified based on the presence of PPROM before delivery: the PPROM group (ruptured membranes >18 hours) and the No PPROM group. The primary outcome was a composite of death or NDI at three years of CA. NDI was considered present if a child had any of the following: cerebral palsy, cognitive score >1 SD below the mean, sensorineural hearing loss or corrected visual acuity < 20/60 in the better eye diagnosed up to 3-year CA.

Results: A total of 1333 eligible infants who survived to discharge were followed up in our regional follow-up clinic at 3 years CA. Out of these 1333 participants, 521 (39%) were in the PPROM group and 812 (61%) were in the non-PPROM group. Infants in the PPROM and No PPROM groups had mean birth weights of 904 (±SD 223) and 876 (±SD 231) grams, respectively, and a median GA of 26 (22-28) weeks for both groups with different characteristics (Table 1). The odds of death or NDI in the PPROM group were 1.22 (95% CI, 0.93 to 1.59) (Table 2). The detailed primary and secondary outcomes with propensity scores matched analyses are shown in the Table 2.

Conclusion(s): Our study suggests that premature preterm rupture of membranes (PPROM) is not associated with an increased risk of a composite outcome of death or neurodevelopmental impairment (NDI) at three years CA.