- 作者：Thibault Mura ; Jean-Charles Picaud ; B¨¦atrice Larroque ; Florence Galtier ; Stephane Marret ; Jean-Christophe Roze ; Patrick Truffert ; Pierre Kuhn ; Jeanne Fresson ; G¨¦rard Thiriez ; Catherine Arnaud ; Gregoire Mercier ; Marie-Christine Picot ; Pierre-Yves Ancel ; Bernard Ledesert ; Etude Epid¨¦miologique sur les Petits Ages Gestationnels (EPIPAGE) Study Group
- 关键词：EPIPAGE ; Etude Epidé ; miologique sur les Petits Ages Gestationnels ; IPL ; Idiopathic preterm labor ; K-ABC ; Kaufman Assessment Battery for Children ; MPC ; Mental Processing Composite ; PPROM ; Preterm premature rupture of membranes ; SGA ; Small for gestati
- 刊名：The Journal of Pediatrics
- 出版年：2013
- 出版时间：August, 2013
- 年：2013
- 卷：163
- 期：2
- 页码：435-440.e2
- 全文大小：443 K
Objective
To evaluate the relationship between preterm premature rupture of membranes (PPROM) and cognitive impairment in 5-year-old children born very preterm.Study design
The Etude Epid¨¦miologique sur les Petits Ages Gestationnels Study is a population-based cohort of children followed up from birth to age 5 years recruited in 9 French regions in 1997. We analyzed data from singletons born between 24 and 32 weeks gestation categorized into 4 groups according to etiology of prematurity: infants born after PPROM, after idiopathic preterm labor, in a vascular context (Vasc), and to women with other complications (Other). Cognitive development at age 5 years was assessed using the Mental Processing Composite score of the Kaufman-Assessment Battery for Children.
Results
Among the 1051 children followed up to age 5 years, the mean Mental Processing Composite score was 93.6 ¡À 19.7, and 13.3 % of the children (140 of 1051) had cognitive impairment. After adjustment for potential confounders, the risk of cognitive impairment among infants in the PPROM group was not significantly different than that in the idiopathic preterm labor group (OR, 1.09; 95 % CI, 0.62-1.92) and the Other group (OR, 1.36; 95 % CI, 0.75-2.47), but was lower than that in the Vasc group (OR, 1.86; 95 % CI, 1.16-2.97). In the PPROM group, the risk of cognitive impairment was greater when the latency period (ie, time from rupture to delivery) was <3 days (OR, 2.32; 95 % CI, 1.07-5.02).
Conclusion
Preterm infants born after PPROM are not at increased risk for cognitive impairment in childhood, but the time between PPROM and birth may influence that risk.