VP49.03: Examining the relationship between previable premature prelabour rupture of membranes and neurodevelopmental outcomes at 18–24 months of age
Bibliographic record
Abstract
To evaluate the neurodevelopmental outcomes at 18–24 months corrected age (CA) following previable premature prelabour rupture of membranes (pPPROM). This is a case-series describing neurodevelopmental outcomes at 18–24 months CA amongst premature children born following pPPROM and seen antenatally in a tertiary-level fetal assessment unit (2009–2015). Cases were identified as neonatal survivors of pPPROM that were seen in a neonatal follow-up clinic at 18–24 months CA. Fetal ultrasound findings (including amniotic fluid volumes at time of ROM), pregnancy outcomes, neonatal complications and survival to hospital discharge were previously collected and cases linked to prospectively-collected neurodevelopmental outcomes stored in a clinical database. The main outcomes of interested were Bayley-III scores & diagnosis of cerebral palsy at 18–24 months CA. 89 of 113 pregnancies with pPPROM were managed expectantly. 25.6% of neonates survived to hospital discharge but only 21.3% survived to 18 months CA. There was no obvious relationship between amniotic fluid volume at ROM and survival. 7/19 survivors (born at median GA of 26+2 weeks) had neurodevelopmental outcomes stored in a clinical database. The mean Bayley-III scores were: cognitive 84.9 (SD 12.2); language 66.4 (SD 18.9); and motor 82.3 (SD 11.5). There were particular deficiencies in language development with all but 1 child scoring at least 1 standard deviation below the population mean and 67% scoring more than 2 standard deviations below the mean. There were no cases of cerebral palsy. Following pPPROM, children in this small study tended to have lower Bayley-III scores than predicted for gestational age at delivery, particularly in language development. While there was no obvious relationship between amniotic fluid volume at time of ROM and survival, we were underpowered to examine the effect on developmental outcomes given the rarity of pPPROM. Larger studies are still required to evaluate the impact previable PPROM on long-term child development.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".