Jantien L van der Heyden1, Christine Willekes2, Anneloes L van Baar3, Aleid G van Wassenaer-Leemhuis4, Eva Pajkrt4, Martijn A Oudijk5, Martina M Porath6, Hans J J Duvekot7, Kitty W M Bloemenkamp8, Mariette Groenewout9, Mallory Woiski10, Bas Nij Bijvank11, Caroline J Bax12, Janneke van 't Hooft4, Marko J M Sikkema13, Bettina M C Akerboom14, Twan A L M Mulder2, Jan G Nijhuis2, Ben Willem J Mol15, David P van der Ham16. 1. Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands. Electronic address: jvdheijden84@hotmail.com. 2. Maastricht University Medical Centre, GROW school for Oncology and Developmental Biology, Maastricht, The Netherlands. 3. Utrecht University, Utrecht, The Netherlands. 4. Academic Medical Centre, Amsterdam, The Netherlands. 5. University Medical Centre Utrecht, Utrecht, The Netherlands. 6. Máxima Medical Centre, Veldhoven, The Netherlands. 7. Erasmus Medical Centre, Rotterdam, The Netherlands. 8. Leids University Medical Centre, Leiden, The Netherlands. 9. University Medical Centre Groningen, Groningen, The Netherlands. 10. University Medical Centre St. Radboud, Nijmegen, The Netherlands. 11. Isala, Zwolle, The Netherlands. 12. VU Medical Centre, Amsterdam, The Netherlands. 13. Ziekenhuisgroep Twente, Almelo, The Netherlands. 14. Albert Schweitzer Hospital, Dordrecht, The Netherlands. 15. Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia. 16. Martini Hospital, Groningen, The Netherlands.
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 >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.
RCT Entities:
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.
Authors: Diana M Bond; Philippa Middleton; Kate M Levett; David P van der Ham; Caroline A Crowther; Sarah L Buchanan; Jonathan Morris Journal: Cochrane Database Syst Rev Date: 2017-03-03
Authors: Emilie V J van Limburg Stirum; Larissa I van der Windt; Charlotte E van Dijk; Anneloes L van Baar; Aleid G Leemhuis; Madelon van Wely; Marjon A de Boer; Janneke van 't Hooft; Martijn A Oudijk; Eva Pajkrt Journal: BMJ Open Date: 2022-08-24 Impact factor: 3.006