Preterm infant outcomes in relation to the gestational age of onset and duration of prelabour rupture of membranes: a retrospective cohort study

Pharande, Pramod; Abdel-Latif, Mohamed E; Bajuk, Barbara; Lui, Kei; Bolisetty, Srinivas

doi:10.1136/bmjpo-2017-000216

Cited by 9 publications

(11 citation statements)

References 29 publications

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“…These differences were still significant after subgroup analysis with the consideration of hypertensive disorders distribution. This was not observed in the Pharande et al study, but comparable results were obtained by other authors [8,14].…”

Section: Discussionsupporting

confidence: 86%

“…Similarly, Pharande et al observed lower prevalence of hypertensive disease of pregnancy in patients with pPROM www. journals.viamedica.pl/ginekologia_polska than with the intact membranes (7.6% vs 26.7%) [8]. Hypothyroidism was also more prevalent in the group without pPROM (19.4% vs 28.7%), which stands in contrast to results of other studies.…”

Section: Discussioncontrasting

confidence: 79%

“…Combined with strict monitoring of maternal inflammation parameters and fetal well-being, this early antimicrobial intervention, adjusted when needed after the antibiogram results analysis, could be the reason that the early onset-sepsis (EOS) rates were similarly distributed among the groups with and without pPROM (7.7% vs 8.9%). Similar observations regarding prophylaxis utility can be made based on other studies, in which antimicrobial prophylaxis was introduced in less than 50% or in over 80% of patients and the rates of EOS cases strongly varied [8,15]. What is more, in a study by Hanke et al, it was proved in a multivariable logistic regression that pPROM is not an independent risk factor for EOS in infants with extremely low birth weight [16].…”

Section: Discussionsupporting

confidence: 71%

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Comparison of maternal characteristics, pregnancy course, and neonatal outcome in preterm births with and without prelabor rupture of membranes

et al. 2020

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Objectives: The aim of this study was to evaluate pregnancy outcome of patients with prelabor rupture of membranes receiving expectant management and giving birth prematurely in comparison to preterm births of patients with intact membranes. Material and methods: It was a retrospective cohort study comparing maternal and neonatal outcome in two groups of preterm births. The first group included 299 consecutive singleton preterm births complicated by prelabor rupture of membranes. The second group consisted of 349 consecutive singleton preterm births without prelabor rupture of membranes. Results: Patients without pPROM underwent Caesarean sections more often than women from the pPROM group (65.3% vs 45.2%; p < 0.001). No statistically significant differences regarding the gestational age during delivery were identified. Lower birth weight was detected in the group with no history of pPROM (p < 0.001). No differences regarding early-onset sepsis were identified and higher percentage of late-onset infections was observed in infants with no history of pPROM (8.9% vs 4.7%; p = 0.04). Pulmonary hypertension was more common in the infants from the pPROM group (4% vs 1.4%; p = 0.049). Neonatal respiratory distress syndrome and respiratory failure were more prevalent in cases of no pPROM history-20% vs 12.7% (p = 0.02) and 40% vs 25.8% (p < 0.001), respectively. Conclusions: Development of multiple complications in preterm neonates may be more associated with the management, gestational age at birth, and birth weight than with the occurrence of preterm prelabor rupture of membranes.

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 79%

Section: Discussionsupporting

confidence: 71%

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Comparison of maternal characteristics, pregnancy course, and neonatal outcome in preterm births with and without prelabor rupture of membranes

et al. 2020

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“…Meanwhile, risk factors for neonatal BPD during pregnancy include intrauterine growth restriction and chorioamnionitis [ 24 ]. One study reported that the incidence rate of BPD was higher in cases who experienced pPROM before 31 weeks of gestation than those who did not experience the condition [ 27 ], Another study reported that from among 36 neonates who were born to mothers diagnosed with pPROM before 24 weeks of gestation and who were discharged following delivery, 17 (47%) developed BPD [ 28 ]. Oligohydramnios was found to be a risk factor for BPD.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for neonatal bronchopulmonary dysplasia in extremely preterm premature rupture of membranes: a retrospective study

Nakamura

Matsunaga

Ono

2020

BMC Pregnancy Childbirth

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Background Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD. Methods This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery. Results The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5 ± 1.9 weeks (mean ± SD), and that at which delivery occurred was 27.0 ± 3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4 ± 20.5 days. The mean birth weight of neonates was 1000 ± 455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusions Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

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“…Meanwhile, risk factors for neonatal BPD during pregnancy include intrauterine growth restriction and chorioamnionitis (21). One study reported that the incidence rate of BPD was higher in cases who experienced pPROM before 31 weeks of gestation than those who did not experience the condition (24), Another study reported that from among 36 neonates who were born to mothers diagnosed with pPROM before 24 weeks of gestation and who were discharged following delivery, 17 (47%) developed BPD (25).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

Nakamura¹,

Matsunaga²,

Ono³

et al. 2020

Preprint

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Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD and the optimal timing for termination of pregnancy in pPROM cases.Methods:Subjects were 73 cases of singleton pregnancy who were diagnosed with pPROM during the period from 22 weeks and 0 days to 27 weeks and 6 days of gestation. The following factors were retrospectively examined: the gestational week at which a diagnosis of pPROM was made; the gestational week at which delivery occurred; the period for which the volume of amniotic fluid was maintained; and neonatal BPD as a complication. A receiver operating characteristic (ROC) curve was drawn in order to analyse the relationship between the duration of oligohydramnios and the onset of BPD.Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. Multivariate analysis of various risk factors for the onset of BPD indicated that oligohydramnios is an independent risk factor for BPD. The ROC curve indicated that the cut-off value was 4 days. In this case, the levels of sensitivity and specificity for predicting the onset of neonatal BPD were 0.941 and 0.917 respectively.Conclusion: Our findings suggest that oligohydramnios is an independent risk factor for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

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Preterm infant outcomes in relation to the gestational age of onset and duration of prelabour rupture of membranes: a retrospective cohort study

Cited by 9 publications

References 29 publications

Comparison of maternal characteristics, pregnancy course, and neonatal outcome in preterm births with and without prelabor rupture of membranes

Comparison of maternal characteristics, pregnancy course, and neonatal outcome in preterm births with and without prelabor rupture of membranes

Risk factors for neonatal bronchopulmonary dysplasia in extremely preterm premature rupture of membranes: a retrospective study

Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

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