Neonatal outcomes in subgroups of women with preterm prelabor rupture of membranes before 34 weeks.
OBJECTIVE
To evaluate the influence of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) on short-term neonatal outcome in women with preterm prelabor rupture of membranes before 34 weeks of gestation.


METHODS
A prospective observational cohort study including 122 pregnant women with PPROM between 24+0 and 34+0. MIAC was defined as a positive PCR result for Ureaplasma species, Mycoplasma hominis and Chlamydia trachomatis and/or positive PCR result for the 16S rRNA gene in the amniotic fluid. HCA was defined according to the Salafia classification. Maternal and short-term neonatal outcomes were evaluated according to the presence or absence of MIAC and/or HCA.


RESULTS
The presence of both MIAC and HCA was observed in 36% (45/122) of women, HCA alone in 34% (41/122) and MIAC in 5% (6/122). A significantly higher incidence of early onset sepsis was observed in newborns born from women with both MIAC and HCA [33% (15/45)] compared with women with HCA alone [12% (5/41)] or MIAC alone [0% (0/6)] or women without MIAC or HCA detected [0% (0/30); p = 0.001].


CONCLUSIONS
The presence of both MIAC and HCA increases the risk of early onset sepsis in pregnancies complicated by preterm prelabor rupture of membranes before 34 weeks of gestation.
a Faculty of Medicine Hradec Kralove, Department of Obstetrics and Gynecology , Charles University in Prague , Hradec Kralove , Czech Republic .
Martin
M
Stepan
b Department of Obstetrics and Gynecology , Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden .|c BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan De Deu), Fetal I + D Fetal Medicine Research Center, Institut D'investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), University of Barcelona, Centre for Biomedical Research on Rare Diseases (CIBER-ER) , Barcelona , Spain .
Teresa
T
Cobo
d Faculty of Medicine Hradec Kralove, Department of Pediatrics , Charles University in Prague , Hradec Kralove , Czech Republic .
Jan
J
Maly
d Faculty of Medicine Hradec Kralove, Department of Pediatrics , Charles University in Prague , Hradec Kralove , Czech Republic .
Martina
M
Navratilova
a Faculty of Medicine Hradec Kralove, Department of Obstetrics and Gynecology , Charles University in Prague , Hradec Kralove , Czech Republic .
Ivana
I
Musilova
e Faculty of Medicine Hradec Kralove, Fingerland's Department of Pathology , Charles University in Prague, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic .
Helena
H
Hornychova
b Department of Obstetrics and Gynecology , Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden .|f Division of Epidemiology, Department of Genes and Environment , Norwegian Institut of Public Health, Oslo University , Oslo , Norway , and.
Bo
B
Jacobsson
a Faculty of Medicine Hradec Kralove, Department of Obstetrics and Gynecology , Charles University in Prague , Hradec Kralove , Czech Republic .|g Biomedical Research Center, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.
Marian
M
Kacerovsky
D000293:Adolescent; D000328:Adult; D000653:Amniotic Fluid / Q000382:microbiology*; D002821:Chorioamnionitis / Q000453:epidemiology* / Q000382:microbiology; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D000071074:Neonatal Sepsis / Q000453:epidemiology*; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
Histological chorioamnionitis; microbial invasion of the amniotic cavity; preterm delivery; short-term neonatal outcome