title: Amniocentesis for threatened preterm labor with intact membranes and the impact on adverse outcome in infants born at 22 to 28 weeks of gestation.
abstract: BACKGROUND
  It remains unclear whether performing amniocentesis to detect intra-amniotic infection is useful for improving neonatal outcomes.
  
  
  OBJECTIVE
  To determine the efficacy of amniocentesis on the neonatal outcomes in women exhibiting threatened preterm labor and intact membranes.
  
  
  METHODS
  Retrospective cohort study
  
  
  METHODS
  A total of 174 women with threatened preterm labor and intact membranes at 22 to 33 weeks of gestation. Women with obvious clinical chorioamnionitis, multifetal pregnancy and/or major anomalies were excluded.
  
  
  METHODS
  Neonatal short- and long-term outcomes
  
  
  RESULTS
  Sixty-seven women underwent amniocentesis (Tap group), while the remaining 107 did not. The prevalence of a positive Gram stain or a positive culture result was 10% in the Tap group. The overall outcomes were not statistically different between the two groups, with the exception of borderline significance (p=0.052) in long-term outcomes, favoring the Tap group. We performed a subgroup analysis focusing on infants born at 22-28 weeks of gestation. Consequently, the Tap group had better neonatal outcomes than the no-Tap group with respect to both short-term (OR 0.19, 95%CI 0.07-0.55) and long-term (OR 0.15, 0.05-0.46) outcomes. A multivariate analysis revealed that after adjusting confounding factors, the gestational age at delivery (OR 0.4, 0.3-0.7) and amniocentesis (OR 0.1, 0.02-0.3) remained significantly different.
  
  
  CONCLUSIONS
  Amniocentesis is useful for improving neonatal outcomes in infants born at 22-28 weeks of gestation to women exhibiting preterm labor and intact membranes.
authors: Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: yohei_maki@med.miyazaki-u.ac.jp.
authors: Yohei
authors: Y
authors: Maki
authors: Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: seishi_furukawa@mcpsed.miyazaki-u.ac.jp.
authors: Seishi
authors: S
authors: Furukawa
authors: Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: yuki_kodama@med.miyazaki-u.ac.jp.
authors: Yuki
authors: Y
authors: Kodama
authors: Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: hsameshima@med.miyazaki-u.ac.jp.
authors: Hiroshi
authors: H
authors: Sameshima
authors: Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: tsuyomu_ikenoue@med.miyazaki-u.ac.jp.
authors: Tsuyomu
authors: T
authors: Ikenoue
mesh_terms: D000328:Adult; D000649:Amniocentesis; D016022:Case-Control Studies; D005321:Extraembryonic Membranes / Q000166:cytology / Q000382:microbiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis* / Q000517:prevention & control
keywords: Amniocentesis; Chorioamnionitis; Intact membrane; Intra-amniotic infection; Long-term; Outcome; Preterm labor