Prolonged latency of preterm premature rupture of membranes and risk of cerebral palsy*

Abstract

Objective: To determine whether prolonged latency after preterm premature rupture of membranes (PPROM) is associated with an increased risk of death or moderate-to-severe cerebral palsy (CP).

Study design: This secondary analysis of the randomized controlled trial of magnesium sulfate for the prevention of CP evaluated whether the time interval between diagnosis of PPROM and delivery was associated with increased risk for CP. Prolonged latency was defined as an interval of ≥4 weeks, latency time was also categorized by week of latency for further analysis. The primary outcome was death or moderate-to-severe CP at 2 years of age. Logistic regression was used to control for confounders.

Results: In all, 1522 patients with PPROM were analyzed; of whom, 1328 had a <4-week interval and 194 had an interval of ≥4 weeks. In the unadjusted analysis, the primary outcome was less likely in the PPROM ≥4 weeks group 4.1% versus 8.4%, RR: 0.49, 95% CI: 0.24–0.98. After adjusting for possible confounders, there was no statistical difference associated with PPROM latency ≥4 weeks versus <4 weeks for death or moderate-to-severe CP.

Conclusion: Prolonged exposure to an intrauterine environment of PPROM does not increase risk for CP.

Keywords:

• Cerebral palsy
• latency
• neurodevelopment
• PPROM

Acknowledgements

This article could not have been completed without the assistance of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Maternal-Fetal Medicine Units Network, and the study Protocol Subcommittee. However, the contents of this report represent the views of the authors and do not represent the views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network or the National Institutes of Health.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.