International multicenter term PROM study: evaluation of predictors of neonatal infection in infants born to patients with premature rupture of membranes at term. Premature Rupture of the Membranes.
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.


METHODS
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), > or = 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.
Department of Obstetrics and Gynecology, Centre for Research in Women's Health, and University of Toronto, Ontario, Canada.
P G
PG
Seaward
M E
ME
Hannah
T L
TL
Myhr
D
D
Farine
A
A
Ohlsson
E E
EE
Wang
E
E
Hodnett
K
K
Haque
J A
JA
Weston
G
G
Ohel
D000328:Adult; D002821:Chorioamnionitis / Q000150:complications / Q000382:microbiology; D036861:Delivery, Obstetric; D005069:Evaluation Studies as Topic; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications*; D005544:Forecasting; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007239:Infections / Q000150:complications* / Q000453:epidemiology; D007391:International Cooperation; D011247:Pregnancy; D013290:Streptococcal Infections / Q000150:complications; D013292:Streptococcus agalactiae