[Premature labour with or without preterm premature rupture of membranes: maternal, obstetric and neonatal features].
OBJECTIVE
Evaluation of maternal, obstetrics e neonatal features in both spontaneous preterm births (PTB) with or without preterm premature rupture of membranes (PPROM).


METHODS
Retrospective study of single fetus pregnancies with PTB between 2003 and 2012.


METHODS
PTB associated with ou without PPROM. Exclusion criterias: PTB by medical indication due to fetal/maternal disease and all non accessible or incomplete clinical files. Different characteristics were compared between two groups of PTB: spontaneous PTB without PPROM (sPTB) versusPPROM. Kolmogorov-Smirnov, Levene, χ2, t Student and Mann-Withney tests were used for statistical analysis.


RESULTS
From 2,393 PTB of single fetus, 1,432 files were analysed, from which 596 were sPTB and 836 PPROM. The socioeconomic conditions were similar in both groups. Multiparity (50.7 versus 40.3%), personal history of previous PTB (20.8 versus10.2%), cervical length (18.2 versus27.2 mm), lower body index mass (23.4 versus 24.3 kg/m2) and higher infectious parameters (Protein C Reactive: 2.2 versus1.2 mg/L; Leukocytes: 13.3 versus 12.4 x109) were more frequent in PBTs (p<0,001). Neonatal outcomes, specially neurologic outcomes (4.7 versus2.8%, p<0,001), were worst in PBTs.


CONCLUSIONS
PTB with or without PPROM has a complex etiology. From all evaluated features in our study, only maternal thinness, multiparity with a previous PTB, the cervical length and worst systemic infections parameters were significant in sPTB. This group also showed worst neonatal outcomes, specially on neurological outcomes.
Serviço de Ginecologia e Obstetrícia A, Centro Hospitalar e Universitário de Coimbra, Coimbra, PT.
Ana Maria Simões
AM
Brandão
Serviço de Ginecologia e Obstetrícia A, Centro Hospitalar e Universitário de Coimbra, Coimbra, PT.
Ana Patrícia Rodrigues
AP
Domingues
Serviço de Ginecologia e Obstetrícia A, Centro Hospitalar e Universitário de Coimbra, Coimbra, PT.
Etelvina Morais Ferreira
EM
Fonseca
Serviço de Ginecologia e Obstetrícia A, Centro Hospitalar e Universitário de Coimbra, Coimbra, PT.
Teresa Maria Antunes
TM
Miranda
Sociedade Portuguesa de Cardiologia, Lisboa, PT.
Adriana
A
Belo
Serviço de Obstetrícia A, Centro Hospitalar e Universitário de Coimbra, Faculdade de Medicina, Universidade de Coimbra, Coimbra, PT.
José Paulo Achando Silva
JP
Moura
D000328:Adult; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D047928:Premature Birth; D012189:Retrospective Studies