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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

Acta obstetricia et gynecologica Scandinavica, 2016-08, Vol.95 (8), p.926-933 [Peer Reviewed Journal]

2016 Nordic Federation of Societies of Obstetrics and Gynecology ;2016 Nordic Federation of Societies of Obstetrics and Gynecology. ;Acta Obstetricia et Gynecologica Scandinavica © 2016 Nordic Federation of Societies of Obstetrics and Gynecology ;ISSN: 0001-6349 ;ISSN: 1600-0412 ;EISSN: 1600-0412 ;DOI: 10.1111/aogs.12905 ;PMID: 27061307 ;CODEN: AOGSAE

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Title:
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
Author: Rodríguez-Trujillo, Adriano ; Cobo, Teresa ; Vives, Irene ; Bosch, Jordi ; Kacerovsky, Marian ; Posadas, David E. ; Ángeles, Martina A. ; Gratacós, Eduard ; Jacobsson, Bo ; Palacio, Montse
Subjects: Age ; Amniotic Fluid - microbiology ; Apgar Score ; Bacteria, Aerobic - isolation & purification ; Bacteria, Anaerobic - isolation & purification ; Chorioamnionitis - diagnosis ; Chorioamnionitis - etiology ; Chorioamnionitis - microbiology ; Female ; Fetal Membranes, Premature Rupture - microbiology ; Gestational Age ; Health risk assessment ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases - etiology ; Infant, Premature, Diseases - therapy ; Inflammation ; Intensive Care, Neonatal - statistics & numerical data ; Interleukin-6 ; intra-amniotic inflammation ; Logistic Models ; Membranes ; microbial invasion of the amniotic cavity ; Microorganisms ; Mycoplasma - isolation & purification ; Obstetrics, Gynecology and Reproductive Medicine ; Pregnancy ; Pregnancy Outcome ; preterm birth ; preterm prelabor rupture of membranes ; Prospective Studies ; Reproduktionsmedicin och gynekologi ; Respiratory distress syndrome ; Short term ; short-term neonatal outcome ; Ureaplasma - isolation & purification
Is Part Of: Acta obstetricia et gynecologica Scandinavica, 2016-08, Vol.95 (8), p.926-933
Description: Introduction 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.
Publisher: United States: Blackwell Publishing Ltd
Language: English;French;German
Identifier: ISSN: 0001-6349
ISSN: 1600-0412
EISSN: 1600-0412
DOI: 10.1111/aogs.12905
PMID: 27061307
CODEN: AOGSAE
Source: Journals@Ovid Open Access Journal Collection Rolling
MEDLINE
Alma/SFX Local Collection

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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

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