Clinic Follow up and Neurological Disability in Children Following Pregnancies Complicated by Preterm Rupture of Membranes and Preeclampsia.

Abstract

Context: Preeclampsia and preterm premature rupture of membranes (PPROM) have been associated with perinatal brain injury. Despite a strong understanding of the relationships between preterm birth and neurologic deficits, and between PPROM and preeclampsia and preterm birth, the relationship between PPROM and preeclampsia and neurologic disability is not well characterized.

Objective: We compared trends in neurologic deficits in children born to mothers with these conditions and described differences in patient characteristics among follow up visit attendance.

Methods: We conducted a prospective cohort study of women with preeclampsia or PPROM. Neurologic deficits were assessed with the Pediatric Stroke Outcome Measure at follow up visits through age 10 years. Eighty nine of the 178 women enrolled completed at least one follow up. Results: Among children born >32 weeks, PPROM showed higher left and right sided sensorimotor deficits at initial follow (p=0.045, p=0.01). In children born ≤ 32 weeks, preeclampsia had higher language production deficits at 3 year follow up (p=0.05).Sensorimotor deficits were greater and sustained in PPROM. Language production deficits were predominant among after 2 years of age in preeclampsia. Racial disparities were found in clinic attendance rates, with Black families most affected.

Conclusion: Differences in neurodevelopmental patterns suggest differences in underlying neuronal injuries. Neurologic assessment should occur routinely throughout early childhood to detect delayed deficits after PPROM and preeclampsia and ensure inclusion of underserved or at risk populations.