Open AccessGestational 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
Author(s) -
RodríguezTrujillo Adriano,
Cobo Teresa,
Vives Irene,
Bosch Jordi,
Kacerovsky Marian,
Posadas David E.,
Ángeles Martina A.,
Gratacós Eduard,
Jacobsson Bo,
Palacio Montse
Publication year - 2016
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12905
Subject(s) - medicine , rupture of membranes , amniotic fluid , gestational age , obstetrics , gestation , pregnancy , chorioamnionitis , inflammation , fetus , immunology , genetics , biology
The aim of this study was to evaluate, in women with preterm prelabor rupture of membranes ( PPROM ), the impact on short‐term neonatal outcome of microbial invasion of the amniotic cavity ( MIAC ), intra‐amniotic inflammation ( IAI ), and the microorganisms isolated in women with MIAC , when gestational age is taken into account. Material and methods Prospective cohort study. We included women with PPROM (22.0–34.0 weeks of gestation) with available information about MIAC , IAI and short‐term neonatal outcome. MIAC was defined as positive aerobic/anaerobic/genital Mycoplasma culture in amniotic fluid. Definition of IAI was based on interleukin‐6 levels in amniotic fluid. Main outcome measures were Apgar score <7 at 5 min, umbilical artery pH ≤7.0, days in the neonatal intensive care unit, and composite neonatal morbidity, including any of the following: intraventricular hemorrhage grade III – IV , respiratory distress syndrome, early‐onset neonatal sepsis, periventricular leukomalacia, necrotizing enterocolitis, and fetal or neonatal death. Labor was induced after 32.0 weeks if lung maturity was confirmed; and otherwise after 34.0 weeks. Results MIAC and IAI were found in 38% (72/190) and 67% (111/165), respectively. After adjustment for gestational age at delivery, no differences in short‐term neonatal outcome were found between women with either MIAC or IAI , compared with the non‐infection/non‐inflammation (“No‐ MIAC /No‐ IAI ”) group. Furthermore, short‐term neonatal outcome did not differ between the MIAC caused by Ureaplasma spp. group, the MIAC caused by other microorganisms group and the “No‐ MIAC /No‐ IAI ” group. Conclusions Gestational age at delivery seems to be more important for short‐term neonatal outcome than MIAC or IAI in PPROM .