Predictors and outcomes of premature rupture of membranes among pregnant women admitted to a teaching Hospital in Saudi Arabia: a cohort study.

IF 2.8 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Hayfaa Wahabi, Hala Elmorshedy, Hanadi Bakhsh, Samia Ahmed, Raghad E AlSubki, Amsha S Aburasyin, Amel Fayed, Amal Mahmoud Ibrahim Goda
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引用次数: 0

Abstract

Background: Premature rupture of the membrane (PROM), refers to rupture of the fetal membranes prior to the onset of regular uterine contractions. When this occurs at term (≥ 37 weeks of gestation), it is classified as PROM, whereas if it occurs before 37 weeks, it is termed preterm premature rupture of membranes (PPROM). PROM and PPROM are linked to adverse outcomes for both mother and newborn.

Objectives: To investigate the factors associated with PROM and the outcomes of pregnancies complicated with PROM.

Methods: This was a retrospective cohort study. The participants were divided into three groups; those with PROM, those with PPROM and a control group who had normal onset of membranes rupture. The groups were compared with respect to predictors of PROM (maternal demographic profile, obstetrical history, and comorbidities), in addition to outcomes (postpartum hemorrhage, hospital stay, low APGAR scores, sepsis, low birthweight, preterm rate, and admission to neonatal Intensive care Unit (NICU)). Multivariable logistic regression model was used for predicting risk factors associated with PROM and PPROM.

Results: A total of 1,894 pregnant women were enrolled in the study, 77.6% had normal onset of ruptured membranes, while 382 (20.1%) were diagnosed with a PROM and 43 (2.3%) diagnosed with PPROM. Primiparous mothers were more likely to develop PROM (AOR = 1.56, 95% CI (1.10-2.22)) as compared to multiparous, while obese and overweight mothers were less likely to develop PPROM (AOR = 0.86, 95% CI (0.94 - 0.49)). Significantly more mothers with PPROM were delivered by emergency cesarean Sect. (30.2% vs. 22.9%, P < 0.01), develop chorioamnionitis (4.7% vs. 0.1%, P < 0.01), and stayed in the hospital more than three days (16.3% vs. 2.5%, P < 0.01) compared to the control group. Neonates of mothers who had PPROM were more likely to have low birth weight (35.7% vs. 10.4%, P < 0.01), and NICU admission (67.4% vs. 20.4%, P < 0.01) as compared to the control group. Perinatal death rate was not significantly different between the groups.

Conclusion: In this study, nulliparity is a predictor of PROM, while overweight/ obese mothers are less likely to develop PPROM. Despite the relatively low occurrence of PPROM among Saudi women, the condition is associate with increase risk of cesarean section delivery, chorioamnionitis, prolonged hospitalization, and an increase need for neonatal intensive care compare to those with a normal onset of membrane rupture.

沙特阿拉伯一家教学医院收治的孕妇胎膜早破的预测因素和结局:一项队列研究
背景:胎膜早破(PROM),是指在正常子宫收缩开始前胎膜破裂。当这种情况发生在足月(≥37周妊娠)时,被归类为胎膜早破,而如果发生在37周之前,则被称为早产胎膜早破(PPROM)。早PROM和PPROM与母亲和新生儿的不良后果有关。目的:探讨胎膜早破的相关因素及妊娠合并胎膜早破的结局。方法:回顾性队列研究。参与者被分成三组;胎膜早破组、胎膜早破组和胎膜破裂正常的对照组。除了结局(产后出血、住院时间、低APGAR评分、败血症、低出生体重、早产率和入住新生儿重症监护病房(NICU))外,还对两组进行了胎膜早破的预测因素(产妇人口统计资料、产科史和合并症)的比较。采用多变量logistic回归模型预测胎膜早破和PPROM相关危险因素。结果:共有1894名孕妇入组,其中77.6%为正常胎膜破裂,382名(20.1%)诊断为胎膜早破,43名(2.3%)诊断为胎膜早破。与多胎母亲相比,初产母亲更容易发生早PROM (AOR = 1.56, 95% CI(1.10-2.22)),而肥胖和超重母亲发生PPROM的可能性较小(AOR = 0.86, 95% CI(0.94 - 0.49))。急诊剖宫产分娩PPROM的母亲明显更多(30.2% vs. 22.9%, P)。结论:在本研究中,无产是早PROM的预测因子,而超重/肥胖母亲发生PPROM的可能性较小。尽管PPROM在沙特妇女中的发生率相对较低,但与正常发生膜破裂的妇女相比,这种情况与剖宫产、绒毛膜羊膜炎、住院时间延长和新生儿重症监护需求增加有关。
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来源期刊
BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-
CiteScore
4.90
自引率
6.50%
发文量
845
审稿时长
3-8 weeks
期刊介绍: BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.
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