TY - JOUR
T1 - Preterm Prelabor Rupture of Membranes
T2 - Outcomes with Expectant Management until 34 versus 35 Weeks
AU - Lynch, Tara A.
AU - Olson-Chen, Courtney
AU - Colihan, Sarah
AU - Meyers, Jeffrey
AU - Holloman, Conisha
AU - Li, Dongmei
AU - Link, Heather
AU - Torres, Paola
AU - Kim, Annie
AU - King, Devon J.
AU - Eckman, Cari
AU - Varlamov, Anna
AU - Dexter, Scott
AU - Pressman, Eva K.
AU - Soto-Torres, Eleazar
AU - Malshe, Amol
N1 - Publisher Copyright:
© 2019 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
PY - 2019
Y1 - 2019
N2 - Objective To evaluate outcomes with expectant management of preterm prelabor rupture of membranes (PROM) until 35 weeks versus immediate delivery at ≥34 weeks. Study Design This was a multicenter retrospective cohort study of singletons with preterm PROM at >20 weeks from 2011 through 2017. Groups were defined as expectant management until 35 weeks versus immediate delivery at ≥34 weeks. Primary outcome was composite neonatal morbidity: need for respiratory support, culture positive neonatal sepsis, or antibiotic administration for >72 hours. Univariate and general estimating equation models were used with p < 0.05 considered significant. Results A total of 280 mother-infant dyads were included. There was no difference in composite neonatal outcome in pregnancies managed with expectant management compared with immediate delivery (43.4 vs. 37.5%; p = 0.32). Those with expectant management had shorter length of neonatal intensive care unit (NICU) admission but higher rates of neonatal antibiotics for > 72 hours, endometritis, and histological chorioamnionitis. There were no cases of fetal demise, neonatal death, or maternal sepsis, and only three cases of neonatal sepsis. Conclusion There is no difference in composite neonatal morbidity in pregnancies with preterm PROM managed with expectant management until 35 weeks as compared with immediate delivery at 34 weeks. Expectant management is associated with a decreased length of NICU admission but increased short-term infectious morbidity.
AB - Objective To evaluate outcomes with expectant management of preterm prelabor rupture of membranes (PROM) until 35 weeks versus immediate delivery at ≥34 weeks. Study Design This was a multicenter retrospective cohort study of singletons with preterm PROM at >20 weeks from 2011 through 2017. Groups were defined as expectant management until 35 weeks versus immediate delivery at ≥34 weeks. Primary outcome was composite neonatal morbidity: need for respiratory support, culture positive neonatal sepsis, or antibiotic administration for >72 hours. Univariate and general estimating equation models were used with p < 0.05 considered significant. Results A total of 280 mother-infant dyads were included. There was no difference in composite neonatal outcome in pregnancies managed with expectant management compared with immediate delivery (43.4 vs. 37.5%; p = 0.32). Those with expectant management had shorter length of neonatal intensive care unit (NICU) admission but higher rates of neonatal antibiotics for > 72 hours, endometritis, and histological chorioamnionitis. There were no cases of fetal demise, neonatal death, or maternal sepsis, and only three cases of neonatal sepsis. Conclusion There is no difference in composite neonatal morbidity in pregnancies with preterm PROM managed with expectant management until 35 weeks as compared with immediate delivery at 34 weeks. Expectant management is associated with a decreased length of NICU admission but increased short-term infectious morbidity.
KW - expectant management
KW - late preterm birth
KW - preterm prelabor rupture of membranes
UR - http://www.scopus.com/inward/record.url?scp=85066743925&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85066743925&partnerID=8YFLogxK
U2 - 10.1055/s-0038-1675647
DO - 10.1055/s-0038-1675647
M3 - Article
C2 - 30553236
AN - SCOPUS:85066743925
SN - 0735-1631
VL - 36
SP - 659
EP - 668
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 7
ER -