Preterm Prelabor Rupture of Membranes: Outcomes with Expectant Management until 34 versus 35 Weeks

Tara A. Lynch, Courtney Olson-Chen, Sarah Colihan, Jeffrey Meyers, Conisha Holloman, Dongmei Li, Heather Link, Paola Torres, Annie Kim, Devon J. King, Cari Eckman, Anna Varlamov, Scott Dexter, Eva K. Pressman, Eleazar Soto-Torres, Amol Malshe

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)659-668
Number of pages10
JournalAmerican Journal of Perinatology
Volume36
Issue number7
DOIs
Publication statusPublished - Jan 1 2019
Externally publishedYes

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Keywords

  • expectant management
  • late preterm birth
  • preterm prelabor rupture of membranes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Lynch, T. A., Olson-Chen, C., Colihan, S., Meyers, J., Holloman, C., Li, D., ... Malshe, A. (2019). Preterm Prelabor Rupture of Membranes: Outcomes with Expectant Management until 34 versus 35 Weeks. American Journal of Perinatology, 36(7), 659-668. https://doi.org/10.1055/s-0038-1675647