Perinatal Outcomes of Late Preterm Rupture of Membranes with or without Latency Antibiotics.

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

American journal of perinatology Pub Date : 2024-10-01 Epub Date: 2024-03-07 DOI:10.1055/a-2282-9072

Mais Abu Nofal, Manal Massalha, Marwa Diab, Maysa Abboud, Aya Asla Jamhour, Waseem Said, Gil Talmon, Samah Mresat, Kamel Mattar, Gali Garmi, Noah Zafran, Ari Reiss, Raed Salim

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引用次数: 0

Abstract

Objective: This study aimed to examine whether the addition of latency antibiotics in late preterm rupture of membranes (ROM) decreases neonatal infection and increases latency.

Study design: This retrospective two-center study was conducted at Holy Family Hospital (HFH) in Nazareth and Emek Medical Center (EMC) in Afula, on data collected between January 2017 and April 2023. HFH is the smaller institution. EMC and HFH implement similar policies regarding ROM at 34^0/7 to 36^6/7 weeks' gestation; the only difference is that a 10-day course of latency antibiotics is implemented at EMC. All women with ROM between 34^0/7 and 36^6/7 weeks' gestation who were admitted to one of the centers during the study period, and had a live fetus without major malformations, were included. The primary outcome was neonatal sepsis rate. Secondary outcomes included a composite of neonatal sepsis, mechanical ventilation ≥24 hours, and perinatal death. Additionally, gestational age at delivery and delivery mode were examined.

Results: Overall, 721 neonates were delivered during the study period: 534 at EMC (where latency antibiotics were administered) and 187 at HFH. The gestational age at ROM was similar (35.8 and 35.9 weeks, respectively, p = 0.14). Neonatal sepsis occurred in six (1.1%) neonates at EMC and one (0.5%) neonate at HFH (adjusted p = 0.71; OR: 1.69; 95% Confidence Interval [CI]: 0.11-27.14). The composite secondary outcome occurred in nine (1.7%) and three (1.6%) neonates at EMC and HFH, respectively (adjusted p = 0.71; OR: 0.73; 95% CI: 0.14-3.83). The gestational age at delivery was 36.1 and 36.2 weeks at EMC and HFH, respectively (mean difference: 5 h; adjusted p = 0.02). The cesarean delivery rate was 24.7% and 19.3% at EMC and HFH, respectively (adjusted p = 0.96).

Conclusion: Latency antibiotics administered to women admitted with ROM between 34^0/7 and 36^6/7 weeks' gestation did not decrease the rate of neonatal sepsis.

Key points: · Latency antibiotics in late preterm ROM does not decrease neonatal sepsis.. · Latency antibiotics in late preterm ROM does not prolong gestational age at delivery.. · Latency antibiotics in late preterm ROM does not affect the mode of delivery..

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使用或不使用潜伏期抗生素的晚期早产胎膜破裂围产期结果。

目的探讨在晚期早产胎膜破裂（ROM）患者中添加潜伏期抗生素是否会减少新生儿感染并增加潜伏期。研究设计本项回顾性双中心研究在拿撒勒的圣家医院（HFH）和阿富拉的埃梅克医疗中心（EMC）进行，数据收集时间为 2017 年 1 月至 2023 年 4 月。圣家医院规模较小。EMC 和 HFH 对妊娠 34 0/7 周至 36 6/7 周的 ROM 实施类似的政策；唯一不同的是，EMC 实施为期 10 天的潜伏抗生素疗程。所有妊娠34 0/7周至36 6/7周之间发生ROM的孕产妇均被纳入研究范围，这些孕产妇必须在研究期间入住其中一家中心，且胎儿为活产且无重大畸形。主要结果是新生儿败血症率。次要结果包括新生儿败血症、机械通气≥24小时和围产期死亡的综合结果。此外，还对分娩时的胎龄和分娩方式进行了研究。结果研究期间共接生了 721 名新生儿：其中 534 例在 EMC 分娩（使用了潜伏期抗生素），187 例在 HFH 分娩。ROM时的胎龄相似（分别为35.8周和35.9周，P=0.14）。EMC和HFH分别有6名（1.1%）和1名（0.5%）新生儿发生新生儿败血症（调整后P=0.71；OR：1.69；95% CI：0.11-27.14）。EMC和HFH分别有9名（1.7%）和3名（1.6%）新生儿出现综合次要结局（调整后P=0.71；OR：0.73；95% CI：0.14-3.83）。EMC 和 HFH 的分娩胎龄分别为 36.1 周和 36.2 周（平均差异：5 小时；调整后 p=0.02）。EMC 和 HFH 的剖宫产率分别为 24.7% 和 19.3%（调整后 p=0.96）。结论对妊娠34 0/7周至36 6/7周期间因ROM入院的产妇使用潜伏期抗生素不会降低新生儿败血症的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.