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.

Autor: van der Heyden JL; Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands. Electronic address: jvdheijden84@hotmail.com., Willekes C; Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands., van Baar AL; Utrecht University, Utrecht, The Netherlands., van Wassenaer-Leemhuis AG; Academic Medical Centre, Amsterdam, The Netherlands., Pajkrt E; Academic Medical Centre, Amsterdam, The Netherlands., Oudijk MA; University Medical Centre Utrecht, Utrecht, The Netherlands., Porath MM; Máxima Medical Centre, Veldhoven, The Netherlands., Duvekot HJ; Erasmus Medical Centre, Rotterdam, The Netherlands., Bloemenkamp KW; Leids University Medical Centre, Leiden, The Netherlands., Groenewout M; University Medical Centre Groningen, Groningen, The Netherlands., Woiski M; University Medical Centre St. Radboud, Nijmegen, The Netherlands., Nij Bijvank B; Isala, Zwolle, The Netherlands., Bax CJ; VU Medical Centre, Amsterdam, The Netherlands., van 't Hooft J; Academic Medical Centre, Amsterdam, The Netherlands., Sikkema MJ; Ziekenhuisgroep Twente, Almelo, The Netherlands., Akerboom BM; Albert Schweitzer Hospital, Dordrecht, The Netherlands., Mulder TA; Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands., Nijhuis JG; Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands., Mol BW; Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia., van der Ham DP; Martini Hospital, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2015 Nov; Vol. 194, pp. 17-23. Date of Electronic Publication: 2015 Aug 03.
DOI: 10.1016/j.ejogrb.2015.07.014
Abstrakt: 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 >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)).
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.
(Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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