Gestational age is more important for short‐term neonatal outcome than microbial invasion of the amniotic cavity or intra‐amniotic inflammation in preterm prelabor rupture of membranes

Rodríguez-Trujillo, Adriano; Cobo, Teresa; Vives, Irene; Bosch, Jordi; Kacerovský, Marian; Posadas, David E.; Ángeles, Martina Aida; Gratacós, E.; Jacobsson, Bo; Palacio, Montse

doi:10.1111/aogs.12905

Cited by 63 publications

(31 citation statements)

References 26 publications

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“…Our findings are in line with those of a previous study by our group in women with PPROM and those reported by others in PTL , highlighting that gestational age at delivery is more important for the short‐term neonatal outcome compared with MIAC in women with PTL without suspicion of clinical chorioamnionitis.…”

Section: Discussionmentioning

confidence: 92%

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Impact of microbial invasion of amniotic cavity and the type of microorganisms on short‐term neonatal outcome in women with preterm labor and intact membranes

Cobo

Vives

Rodríguez-Trujillo

et al. 2017

Acta Obstet Gynecol Scand

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Microbial invasion of the amniotic cavity by microorganisms other than Ureaplasma spp. was associated with earlier gestational age at admission and at delivery, and a higher rate of preterm delivery <24.0 weeks and of women who developed clinical chorioamnionitis. However, we did not find differences in the short-term neonatal outcome between women exposed to microbial invasion of the amniotic cavity and the no-microbial invasion of the amniotic cavity/no-intra-amniotic inflammation group delivering after 24.0 weeks' gestation when adjusted by gestational age at delivery.

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Section: Discussionmentioning

confidence: 92%

“…MIAC by Ureaplasma spp. has been suggested to be a chronic process that generates a progressive and stronger inflammatory response similar to that observed by microorganisms other than Ureaplasma spp .…”

Section: Introductionmentioning

confidence: 99%

Impact of microbial invasion of amniotic cavity and the type of microorganisms on short‐term neonatal outcome in women with preterm labor and intact membranes

Cobo

Vives

Rodríguez-Trujillo

et al. 2017

Acta Obstet Gynecol Scand

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“…In a recent report with a relatively large sample size, Lee et al showed that the higher incidence of neonatal morbidity according to increased stage of HCA or funisitis was due to an earlier gestational age at delivery [21]. Similarly, in terms of the association of MIAC and elevated AF IL-6 levels with neonatal morbidity, Rodriguez-Trujillo et al and Comb et al demonstrated that these significant associations disappeared after adjusting for gestational age at delivery [22, 23]. In concurrence to the results of previous studies [21–23], our results showed that HCA with negative AF culture was associated with increased risk of composite neonatal morbidities, but this risk is dependent on gestational age at birth.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of histologic chorioamnionitis with a negative amniotic fluid culture in patients with preterm labor and premature membrane rupture

Park

Jung

2017

PLoS ONE

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ObjectiveTo evaluate the effect of histological chorioamnionitis (HCA) with a negative amniotic fluid (AF) culture on adverse pregnancy and neonatal outcomes and inflammatory status in the AF compartment in women with preterm labor or preterm premature rupture of membranes (PPROM).MethodsThis is a retrospective cohort study of 153 women diagnosed as having a preterm labor or PPROM (20–34 weeks) who delivered singleton gestations within 48 hours of amniocentesis. AF obtained through amniocentesis was cultured, and interleukin (IL)-6, IL-8, and metalloproteinase-9 (MMP-9) levels were determined. The placentas were examined histologically.ResultsThe prevalence of HCA with negative AF culture was 23.5% (36/153). The women with HCA but with a negative AF culture (group 2) and those with a positive AF culture (group 3) had a significantly lower mean gestational age at amniocentesis and delivery than those with a negative AF culture and without HCA (group 1). Women in group 3 had the highest levels of AF IL-6, IL-8, and MMP-9, followed by those in group 2, and those in group 1. Composite neonatal morbidity was significantly higher in groups 2 and 3 than in group 1, but this was no longer significant after adjusting for confounders caused mainly by the impact of gestational age.DiscussionIn the women who delivered preterm neonates, HCA with a negative AF culture was associated with increased risks of preterm birth, intense intra-amniotic inflammatory response, and prematurity-associated composite neonatal morbidity, and its risks are similar to the risk posed by positive AF culture.

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“…[2,6,27] These factors are difficult to modify given current neonatal intensive care unit (NICU) therapies. Together and individually, they reflect the severity of illness of the infant.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors and clinical practice profile for strictures post-necrotising enterocolitis

Zhang

Chen

Wang³

et al. 2017

Medicine

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Intestinal stricture is a severe and common complication of necrotizing enterocolitis (NEC), causing severe and prolonged morbidity. Our goal was to investigate the clinical predictors for strictures developing after NEC and evaluate the management outcome of the post-NEC strictures to better orient their medicosurgical care.A total of 188 patients diagnosed with NEC with identical treatment protocols throughout the period under study were retrospectively reviewed from 4 academic neonatal centers between from January 1, 2011, and October 31, 2016. Clinical predictive factors and clinical outcomes, including demographic information, clinical management, laboratory data, histopathology of resected bowel segment, and discharge summaries, were evaluated on the basis of with post-NEC strictures or not.Of the involved variables examined, the late-onset NEC [risk ratio (RR), 0.56; 95% confidence interval (95% CI), 0.41–0.92; P < 0.001], cesarean delivery (RR, 1.42; 95% CI, 0.98–2.29; P = 0.026), and first procalcitonin (PCT) (onset of symptoms) (RR, 1.82; 95% CI, 0.98–3.15; P = 0.009) were the independent predictive factors for the post-NEC strictures. C-reactive protein (CRP), white blood cell (WBC), and plateletcrit levels were markedly higher on infants with stricture and elevated levels were maintained until the stricture was healed. Infants with intestinal stricture had significantly longer times to beginning enteral feeds (23.9 ± 12.1), than infants without intestinal stricture (18.6 ± 8.8) (P = 0.023). The median age at discharge was also significantly higher in the group with stricture (P = 0.014).This retrospective and multicenter study demonstrates that the early-onset NEC and cesarean delivery conferred protection over the post-NEC stricture. Infants with post-NEC stricture need prolonged hospitalization.

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Gestational age is more important for short‐term neonatal outcome than microbial invasion of the amniotic cavity or intra‐amniotic inflammation in preterm prelabor rupture of membranes

Abstract: Gestational age at delivery seems to be more important for short-term neonatal outcome than MIAC or IAI in PPROM.

Cited by 63 publications

References 26 publications

Impact of microbial invasion of amniotic cavity and the type of microorganisms on short‐term neonatal outcome in women with preterm labor and intact membranes

Impact of microbial invasion of amniotic cavity and the type of microorganisms on short‐term neonatal outcome in women with preterm labor and intact membranes

Clinical significance of histologic chorioamnionitis with a negative amniotic fluid culture in patients with preterm labor and premature membrane rupture

Predictive factors and clinical practice profile for strictures post-necrotising enterocolitis

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