title: Can neonatal sepsis be predicted in late preterm premature rupture of membranes? Development of a prediction model.
abstract: OBJECTIVE
  Women with late preterm premature rupture of membranes (PROM) have an increased risk that their child will develop neonatal sepsis. We evaluated whether neonatal sepsis can be predicted from antepartum parameters in these women.
  
  
  METHODS
  We used multivariable logistic regression to develop a prediction model. Data were obtained from two recent randomized controlled trials on induction of labor versus expectant management in late preterm PROM (PPROMEXIL trials, (ISRCTN29313500 and ISRCTN05689407). Data from randomized as well as non-randomized women, who consented to the use of their medical data, were used. We evaluated 13 potential antepartum predictors for neonatal sepsis. Missing data were imputed. Discriminative ability of the model was expressed as the area under the receiver operating characteristic (ROC) curve and a calibration with both a calibration plot and the Hosmer and Lemeshow goodness-of-fit test. Overall performance of the prediction model was quantified as the scaled Brier score.
  
  
  RESULTS
  We studied 970 women. Thirty-three (3.4%) neonates suffered neonatal sepsis. Maternal age (OR 1.09 per year), maternal CRP level (OR 1.01 per mmol/l), maternal temperature (OR 1.80 per °C) and positive GBS culture (OR 2.20) were associated with an increased risk of neonatal sepsis. The model had an area under the ROC-curve of 0.71. The model had both a good calibration and accuracy.
  
  
  CONCLUSIONS
  Antepartum parameters aid in the more precise prediction of the risk of neonatal sepsis in women with late preterm PPROM.
authors.affiliation: Department of Obstetrics and Gynecology, Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, PO Box 5800, 6202 AZ Maastricht, The Netherlands; Department of Obstetrics and Gynecology, Martini Hospital Groningen, PO Box 30033, 9700 RB Groningen, The Netherlands. Electronic address: dpvanderham@gmail.com.
authors.forename: David P
authors.initials: DP
authors.lastname: van der Ham
authors.affiliation: Department of Obstetrics and Gynecology, Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Sander
authors.initials: S
authors.lastname: van Kuijk
authors.affiliation: Clinical Research Unit, Academic Medical Centre Amsterdam, PO Box 22700, 1105 DE Amsterdam, The Netherlands.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Opmeer
authors.affiliation: Department of Obstetrics and Gynecology, Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Christine
authors.initials: C
authors.lastname: Willekes
authors.affiliation: Department of Obstetrics and Gynecology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, The Netherlands.
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: van Beek
authors.affiliation: Department of Pediatrics, Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Antonius L M
authors.initials: AL
authors.lastname: Mulder
authors.affiliation: Department of Obstetrics and Gynecology, Martini Hospital Groningen, PO Box 30033, 9700 RB Groningen, The Netherlands.
authors.forename: Aren J
authors.initials: AJ
authors.lastname: van Loon
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
authors.forename: Martiët
authors.initials: M
authors.lastname: Groenewout
authors.affiliation: Department of Obstetrics and Gynecology, Isala Klinieken Zwolle, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands.
authors.forename: Gerald D
authors.initials: GD
authors.lastname: Mantel
authors.affiliation: Department of Obstetrics and Gynecology, Leiden University Medical Centre, Albiniusdreef 2, 2333 ZA Leiden, The Netherlands.
authors.forename: Kitty W M
authors.initials: KW
authors.lastname: Bloemenkamp
authors.affiliation: Department of Obstetrics and Gynecology, Maxima Medical Centre Veldhoven, De Run 4600, 5504 DB Veldhoven, The Netherlands.
authors.forename: Martina
authors.initials: M
authors.lastname: Porath
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: Kwee
authors.affiliation: Department of Obstetrics and Gynecology, Albert Schweitzer Hospital Dordrecht, Albert Schweitzerplaats 25, 3318 AT Dordrecht, The Netherlands.
authors.forename: Bettina M C
authors.initials: BM
authors.lastname: Akerboom
authors.affiliation: Department of Obstetrics and Gynecology, Amphia Hospital Breda, Langendijk 75, 4819 EV Breda, The Netherlands.
authors.forename: Dimitri N M
authors.initials: DN
authors.lastname: Papatsonis
authors.affiliation: Department of Obstetrics and Gynecology, Ikazia Hospital Rotterdam, Montessoriweg 1, 3083 AN Rotterdam, The Netherlands.
authors.forename: Godfried C H
authors.initials: GC
authors.lastname: Metz
authors.affiliation: Department of Obstetrics and Gynecology, Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Jan G
authors.initials: JG
authors.lastname: Nijhuis
authors.affiliation: Department of Obstetrics and Gynecology, School of Paediatrics and Reproductive Health, University of Adelaide, 5000 SA, Australia.
authors.forename: Ben W J
authors.initials: BW
authors.lastname: Mol
mesh_terms: D000328:Adult; D001831:Body Temperature; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology*; D008875:Middle Aged; D008954:Models, Biological; D011247:Pregnancy; D011379:Prognosis; D012372:ROC Curve; D012306:Risk; D018805:Sepsis / Q000209:etiology*
chemical_list: D002097:C-Reactive Protein
keywords: Late preterm premature rupture of membranes; Neonatal sepsis; PPROM; Predicting; Prediction model