Preterm premature rupture of membranes: does the duration of latency influence perinatal outcomes?

Full Abstract

OBJECTIVE: Preterm premature rupture of membranes (PPROM) is the leading identifiable cause of prematurity. We hypothesized that, when controlled for delivery gestational age, potential prolonged exposure to inflammation/infection could be harmful to the developing fetus. STUDY DESIGN: We studied a retrospective cohort of pregnancies with PPROM at 22.0-33.9 weeks' gestation. The primary outcome was perinatal survival without major morbidity (grade III/IV intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia). Regression models assessed predictors of perinatal morbidity. RESULTS: Three hundred six women were included. PPROM occurred at a median of 29.4 weeks' gestation (interquartile range [IQR], 24.7-32.1 weeks' gestation). Median latency was 8 days (IQR, 3-15 days). Median delivery age was 31.4 weeks' gestation (IQR, 27.4-33.3 weeks' gestation). Two hundred seventy-seven infants (91%) survived; 233 infants (84% of survivors, 76% of all babies) did not have major morbidities. Gestational age (odds ratio, 0.60; 95% confidence interval, 0.53-0.68) and congenital sepsis (odds ratio, 13.2; 95% confidence interval, 3.9-44.5), but not latency, predicted perinatal morbidity in multivariate models. CONCLUSION: Latency does not appear to worsen outcomes in pregnancies that are complicated by PPROM.

Author information

Author/s: Manuck, Tracy A (TA); Maclean, Courtney C (CC); Silver, Robert M (RM); Varner, Michael W (MW);

Affiliation: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA. tracy.manuck(-atsign-)hsc.utah.edu

Journal and publication information

Publication Type: Journal Article

Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol), published in United States. (Language: eng)

Reference: 2009-Oct; vol 201 (issue 4) : pp 414.e1-6

Dates: Created 2009/09/30; Completed 2009/10/22;

PMID: 19788972, status: MEDLINE (last retrieval date: 10/22/2009, IMS Date: )

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