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Neonatal outcomes are associated with latency after preterm premature rupture of membranes

Journal of Perinatology volume 32, pages 970–977 (2012)Cite this article

Subjects

Abstract

Objective:

To determine factors associated with latency time to birth after preterm premature rupture of membranes (PPROM) and the impact on neonatal outcomes.

Study Design:

Data on singleton pregnancies with PPROM (n=1535 infants) were prospectively collected in a computerized perinatal/neonatal database at a tertiary care perinatal center. Latency was characterized as ⩽72h versus >72 h after PPROM.

Result:

The percentage of women with latency to birth >72 h decreased from 67% in very preterm (gestational age (GA) 25 to 28 weeks) to 10% in late preterm women (GA 33 to 36 weeks). PPROM women with latency ⩽72 h were more likely to have pregnancy-induced hypertension and birth weight <3%; PPROM women with latency >72 h were more likely to have received steroids and develop clinical chorioamnionitis. PPROM <32 weeks GA with latency ⩽72 h was associated with a two-fold higher incidence of severe neonatal morbidity, while PPROM between 29 to 34 weeks GA and latency ⩽72 h was associated with a higher incidence of moderate neonatal morbidity.

Conclusion:

A latency period >72 h was associated with a decreased incidence of adverse neonatal outcomes up to 32 weeks GA for severe and 34 weeks GA for moderate morbidity indices.

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Acknowledgements

We thank Dr Larry Stitt for statistical assistance, Gail Schmidt and Maria Sinacori for technical assistance, and Dr Renato Natale for his support of the perinatal database. Dr Dan Nayot received a Schulich Research Opportunities Program grant for his work on this project and Dr Barbra de Vrijer was supported by the Strategic Training Initiative in Research in the Reproductive Health Sciences (STIRRHS). Bryan S Richardson is the recipient of the Canada Research Chair in Fetal and Neonatal Health and Development. This paper has been presented SOGC 63rd Annual Clinical Meeting, 2007 (oral), and at the Society for Gynecological Investigation 55th Annual Meeting, 2008 (poster). Research was supported by the Schulich Research Opportunities Program, the Strategic Training Initiative in Research in the Reproductive Health Sciences (STIRRHS), and the Canada Research Chair in Fetal and Neonatal Health and Development.

Contribution to Authorship

Dr Dan Nayot contributed to the conception and design of the study, analyzed the data and prepared the manuscript. Drs Barbra de Vrijer and Debbie Penava, Orlando Da Silva and Bryan Richardson contributed to the conception and design of the study, guided the data analysis and helped critically revise the manuscript. All authors gave final approval to the manuscript for submission.

Details of Ethics Approval

This project was approved by the Health Sciences Research Ethics Board at the University of Western Ontario, London, Ontario, Canada (HSREB 12561E).

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Children Health Research Institute, University of Western Ontario, London, ON, Canada

    D Nayot, D Penava, B S Richardson & B de Vrijer

  2. Department of Pediatrics, Children Health Research Institute, University of Western Ontario, London, ON, Canada

    O Da Silva

  3. Physiology/Pharmacology, Children Health Research Institute, University of Western Ontario, London, ON, Canada

    O Da Silva & B S Richardson

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  1. D Nayot
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  2. D Penava
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Correspondence to B de Vrijer.

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Nayot, D., Penava, D., Da Silva, O. et al. Neonatal outcomes are associated with latency after preterm premature rupture of membranes. J Perinatol 32, 970–977 (2012). https://doi.org/10.1038/jp.2012.15

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