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Neonatal outcomes in subgroups of women with preterm prelabor rupture of membranes before 34 weeks |
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| Authors: | Martin Stepan Teresa Cobo Jan Maly Martina Navratilova Ivana Musilova Helena Hornychova |
| Institution: | 1. Faculty of Medicine Hradec Kralove, Department of Obstetrics and Gynecology, Charles University in Prague, Hradec Kralove, Czech Republic, mstepan.hk@post.cz;3. Department of Obstetrics and Gynecology, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden,;4. BCNatal – Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan De Deu), Fetal I?+?D Fetal Medicine Research Center, Institut D’investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), University of Barcelona, Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain,;5. Faculty of Medicine Hradec Kralove, Department of Pediatrics, Charles University in Prague, Hradec Kralove, Czech Republic,;6. Faculty of Medicine Hradec Kralove, Department of Obstetrics and Gynecology, Charles University in Prague, Hradec Kralove, Czech Republic,;7. Faculty of Medicine Hradec Kralove, Fingerland’s Department of Pathology, Charles University in Prague, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic, |
| Abstract: | Objective: To evaluate the influence of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) on short-term neonatal outcome in women with preterm prelabor rupture of membranes before 34 weeks of gestation.Methods: A prospective observational cohort study including 122 pregnant women with PPROM between 24+0 and 34+0. MIAC was defined as a positive PCR result for Ureaplasma species, Mycoplasma hominis and Chlamydia trachomatis and/or positive PCR result for the 16S rRNA gene in the amniotic fluid. HCA was defined according to the Salafia classification. Maternal and short-term neonatal outcomes were evaluated according to the presence or absence of MIAC and/or HCA.Results: The presence of both MIAC and HCA was observed in 36% (45/122) of women, HCA alone in 34% (41/122) and MIAC in 5% (6/122). A significantly higher incidence of early onset sepsis was observed in newborns born from women with both MIAC and HCA 33% (15/45)] compared with women with HCA alone 12% (5/41)] or MIAC alone 0% (0/6)] or women without MIAC or HCA detected 0% (0/30); p?=?0.001].Conclusions: The presence of both MIAC and HCA increases the risk of early onset sepsis in pregnancies complicated by preterm prelabor rupture of membranes before 34 weeks of gestation. |
| Keywords: | Histological chorioamnionitis microbial invasion of the amniotic cavity preterm delivery short-term neonatal outcome |