Three-Year Outcome of Very Low Birth Weight Infants in Conservatively Managed Premature Rupture of Membranes

Aim: To elucidate the outcome for very low birth weight infants delivered after preterm premature rupture of membranes (PPROM) managed conservatively, and to determine the prognostic value of perinatal factors for long-term outcome. Methods: Perinatal data were collected from medical records for singleton live-birth infants delivered between 1991 and 2008 after conservatively managed PPROM. Cases of congenital anomalies and chromosomal aberrations were excluded. Poor outcome was defined as a composite measure of death, neurological morbidity including cerebral palsy, or neurodevelopmental delay. Associations between perinatal factors and poor outcome at the corrected age of 3 were estimated using logistic regression analysis. Results: After the exclusion, 356 infants meeting the study criteria were identified, 26 cases were lost to follow-up, and 330 were eligible at 3 years. The mortality rate was 10% and the incidence of neurological morbidities was 12%. Logistic regression analysis revealed gestational age at birth [adjusted odds ratio (aOR) 0.815], and five-minute Apgar scores (aOR 0.521) were independent predictors for poor outcome. Conclusion: When PPROM was managed conservatively, 22% of VLBW infants had a poor outcome at corrected age of 3 years. Early gestational age at birth and low Apgar scores were associated with poor outcome. Corresponding author.