Neonatal and two-year outcomes after rupture of membranes before 25 weeks of gestation

Eur J Obstet Gynecol Reprod Biol. 2013 Feb;166(2):145-50. doi: 10.1016/j.ejogrb.2012.10.014. Epub 2012 Oct 31.


Objective: To assess the impact of extreme preterm premature rupture of membranes (PPROM) <25 weeks of gestation on preterm child outcome.

Study design: Retrospective study comparing the neonatal and 2-year outcomes of infants exposed to extremely PPROM <25 weeks with a non-exposed group of neonates in a tertiary care referral centre located in Paris, France, between 2003 and 2007. All women with singleton pregnancy and PPROM between 15(0/7) and 24(6/7) weeks of gestation were recruited. For each infant born alive, the next inborn neonate matched for gestational age and sex was selected as a control among neonates born alive after spontaneous preterm labour with intact membranes. The main outcome measures were neonatal outcome assessed by a combined criterion of adverse neonatal outcomes and the two-year neurodevelopmental outcome assessed by developmental Brunet-Lézine tests and neurological examinations.

Results: In 78 cases of extremely PPROM, 22 live births occurred at a mean gestational age of 26(5/7) weeks. The percentage of neonates with adverse neonatal outcomes was significantly higher among PPROM than non-exposed cases (68.2 versus 27.3%). At 2 years of age, children from the PPROM group were more likely to have delayed acquisitions (64.3 versus 15.8%) and behavioural disorders (57.1 versus 15.8%). Mean Brunet-Lézine language score was significantly lower among those infants (78.9 versus 96.8).

Conclusion: PPROM <25 weeks is associated with increased neonatal mortality and morbidity and with increased risks of delayed acquisitions, behavioural disorders and lower language performance scores at 2 years in comparison with matched preterm neonates born after spontaneous preterm labour with intact membranes.

MeSH terms

  • Adult
  • Child Development
  • Child, Preschool
  • Developmental Disabilities / epidemiology
  • Female
  • Fetal Membranes, Premature Rupture / epidemiology*
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Language Development
  • Language Development Disorders / epidemiology
  • Paris / epidemiology
  • Pregnancy
  • Retrospective Studies
  • Young Adult