title: Preterm prelabour rupture of membranes: effect of latency on neonatal and maternal outcomes.
abstract: OBJECTIVE
  To compare risks of infection and prematurity-related outcomes according to latency periods among women with preterm prelabour rupture of membranes (PPROM).
  
  
  METHODS
  Women with PPROM occurring between 24+0 and 36+6 weeks of gestation were identified from a provincial population-based perinatal database in Nova Scotia. The primary outcomes included composite variables for serious maternal and neonatal infectious morbidity and neonatal prematurity-related morbidity. Logistic regression was used to quantify the relationship between latency period (< 24 hours, 24 hours to < 48 hours, 48 hours to < 7 days, and ≥ 7 days) and maternal and neonatal outcomes. Separate analyses were conducted for gestational age groups 24+0 to 33+6 weeks and 34+0 to 36+6 weeks.
  
  
  RESULTS
  There were 4329 women included in the cohort. The composite variables representing serious maternal or neonatal infectious morbidity were not significantly associated with latency for either gestational age group. For PPROM occurring at gestational ages of 24+0 to 33+6 weeks, the odds of neonatal prematurity-related morbidity were significantly decreased at the latency periods of 48 hours or more compared with < 24 hours latency. For PPROM at 34+0 to 36+6 weeks of gestation, the odds of prematurity-related morbidity at 48 hours to < 7 days latency was decreased compared with latencies < 24 hours (OR 0.4; 95% CI 0.2 to 0.8).
  
  
  CONCLUSIONS
  Postponing delivery following PPROM may contribute to less prematurity-related morbidity, even close to term, without putting mother or neonate at substantial risk for serious infectious morbidity. Generalization of these findings to other obstetric populations should be informed by the underlying risk of infection.
authors.affiliation: Faculty of Medicine, Dalhousie University, Halifax NS.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Frenette
authors.affiliation: Perinatal Epidemiology Research Unit, Dalhousie University, Halifax NS; Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS; Department of Pediatrics, Dalhousie University, Halifax NS.
authors.forename: Linda
authors.initials: L
authors.lastname: Dodds
authors.affiliation: Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS.
authors.forename: B Anthony
authors.initials: BA
authors.lastname: Armson
authors.affiliation: Department of Pediatrics, Dalhousie University, Halifax NS.
authors.forename: Krista
authors.initials: K
authors.lastname: Jangaard
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D016015:Logistic Models; D009017:Morbidity; D009674:Nova Scotia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D013997:Time Factors
keywords: infection; morbidity; neonatal prematurity; premature rupture of fetal membranes