Abstract
OBJECTIVE: Our objective was to determine significant predictors for the development of neonatal
infection in infants born to patients with premature rupture of membranes at term.
STUDY DESIGN: Multivariate analysis was used to determine the significant predictors of neonatal
infection in infants born to women with premature rupture of the membranes who were
enrolled in the Term PROM Study. In a randomized, controlled trial, the Term PROM
Study recently compared induction of labor with expectant management for premature
rupture of membranes at term.
RESULTS: The following variables were identified as independent predictors of neonatal infection:
clinical chorioamnionitis (odds ratio 5.89, P < .0001), positive maternal group B streptococcal status (vs negative or unknown,
odds ratio 3.08, P < .0001), 7 to 8 vaginal digital examinations (vs 0 to 2, odds ratio 2.37, P = .04), 24 to <48 hours from membrane rupture to active labor (vs <12 hours, odds
ratio 1.97, P = .02), ≥ 48 hours from membrane rupture to active labor (vs <12 hours, odds ratio
2.25, P = .01), and maternal antibiotics before delivery (odds ratio 1.63, P = .05).
CONCLUSIONS: Among infants born to patients with premature rupture of membranes at term, clinical
chorioamnionitis and maternal colonization with group B streptococci are the most
important predictors of subsequent neonatal infection. (Am J Obstet Gynecol 1998;179:635-9.)
Keywords
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Article Info
Publication History
Accepted:
January 19,
1998
Received in revised form:
October 8,
1997
Received:
August 26,
1997
Footnotes
☆From the Division of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecologya and Paediatricsb, the Maternal, Infant and Reproductive Health Research Unit, Centre for Research in Women’s Health,c and the Faculty of Nursing,d University of Toronto, the Department of Pediatrics, St Helier,e and the Department of Obstetrics and Gynecology, Bnai Zion Medical Centre.
☆☆Supported by grant No MA-11392 from the Medical Research Council of Canada.
★Reprint requests: P.G.R. Seaward, MB, BCh, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Mt Sinai Hospital, Suite 775B, 600 University Ave, Toronto, Ontario, Canada M5G 1X5.
★★0002-9378/98 $5.00 6/1/88944
Identification
Copyright
© 1998 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
