title: Impact of Latency Duration on the Prognosis of Preterm Infants after Preterm Premature Rupture of Membranes at 24 to 32 Weeks' Gestation: A National Population-Based Cohort Study.
abstract: To assess the impact of latency duration on survival, survival without severe morbidity, and early-onset sepsis in infants born after preterm premature rupture of membranes (PPROM) at 24-32 weeks' gestation.
  
  
  
  This study was based on the prospective national population-based Etude Épidémiologique sur les Petits Ȃges Gestationnels 2 cohort of preterm births and included 702 singletons delivered in France after PPROM at 24-32 weeks' gestation. Latency duration was defined as the time from spontaneous rupture of membranes to delivery, divided into 4 periods (12 hours to 2 days [reference], 3-7 days, 8-14 days, and >14 days). Multivariable logistic regression was used to assess the relationship between latency duration and survival, survival without severe morbidity at discharge, or early-onset sepsis.
  
  
  
  Latency duration ranged from 12 hours to 2 days (18%), 3-7 days (38%), 8-14 days (24%), and >14 days (20%). Rates of survival, survival without severe morbidity, and early-onset sepsis were 93.5% (95% CI 91.8-94.8), 85.4% (82.4-87.9), and 3.4% (2.0-5.7), respectively. A crude association found between prolonged latency duration and improved survival disappeared on adjusting for gestational age at birth (aOR 1.0 [reference], 1.6 [95% CI 0.8-3.2], 1.2 [0.5-2.9], and 1.0 [0.3-3.2] for latency durations from 12 hours to 2 days, 3-7 days, 8-14 days, and >14 days, respectively). Prolonged latency duration was not associated with survival without severe morbidity or early-onset sepsis.
  
  
  
  For a given gestational age at birth, prolonged latency duration after PPROM does not worsen neonatal prognosis.
authors.affiliation: Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Sorbonne Universités, University Pierre and Marie Curie, Paris 06, Institut de Formation Doctorale, Paris, France. Electronic address: elsa.lorthe@gmail.com.
authors.forename: Elsa
authors.initials: E
authors.lastname: Lorthe
authors.affiliation: Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Unité de Recherche Clinique-Centre d'Investigations Cliniques P1419, Cochin Hotel-Dieu Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Ancel
authors.affiliation: Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France.
authors.forename: Héloïse
authors.initials: H
authors.lastname: Torchin
authors.affiliation: Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Kaminski
authors.affiliation: Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Langer
authors.affiliation: Department of Obstetrics and Gynecology, Jeanne de Flandre Hospital, Lille, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Subtil
authors.affiliation: Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Sentilhes
authors.affiliation: Research Unit on Perinatal Epidemiology, Childhood Disabilities and Adolescent Health, Inserm UMR 1027, Paul Sabatier University, Toulouse, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Arnaud
authors.affiliation: Department of Obstetrics and Gynecology, Princess Grace Hospital, Monaco.
authors.forename: Bruno
authors.initials: B
authors.lastname: Carbonne
authors.affiliation: Department of Neonatal Pediatrics, University Hospital, Grenoble, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Debillon
authors.affiliation: Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Department of Obstetrics and Gynecology, Cochin, Broca, Hôtel Dieu Hospital, AP-HP, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Delorme
authors.affiliation: Department of Obstetrics and Gynecology, Nord Hospital, Assistance Publique des Hôpitaux de Marseille (AP-HM), Aix Marseille Université, Marseille, France.
authors.forename: Claude
authors.initials: C
authors.lastname: D'Ercole
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Caen, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Dreyfus
authors.affiliation: Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Lebeaux
authors.affiliation: Department of Biostatistics and Medical Information (ECSTRA Team), Centre of Research in Epidemiology and Statistics Sorbonne, Inserm UMR 1153, Université Paris Diderot, Paris, France.
authors.forename: Jacques-Emmanuel
authors.initials: JE
authors.lastname: Galimard
authors.affiliation: Research Unit on Perinatal Epidemiology, Childhood Disabilities and Adolescent Health, Inserm UMR 1027, Paul Sabatier University, Toulouse, France; Department of Obstetrics and Gynecology, University Hospital, Toulouse, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Vayssiere
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital, National Institute for Agricultural Research, UMR 1280 Physiologie des adaptations nutritionnelles, Nantes, France.
authors.forename: Norbert
authors.initials: N
authors.lastname: Winer
authors.affiliation: Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Department of Neonatal Pediatrics, Trousseau Hospital, AP-HP, Paris, France.
authors.forename: Laurence Foix
authors.initials: LF
authors.lastname: L'Helias
authors.affiliation: Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Department of Obstetrics and Gynecology, Cochin, Broca, Hôtel Dieu Hospital, AP-HP, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Goffinet
authors.affiliation: Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Sorbonne Universités, University Pierre and Marie Curie, Paris 06, Institut de Formation Doctorale, Paris, France; Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Kayem
mesh_terms: D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005602:France; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011247:Pregnancy; D047928:Premature Birth; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors
keywords: EPIPAGE 2; early-onset sepsis; expectant management; latency; perinatal outcome; prematurity; preterm premature rupture of membranes; survival