早产胎膜破裂孕妇48 小时或以上分娩的预测因素：一项回顾性队列研究

IF 1.5 Q3 OBSTETRICS & GYNECOLOGY

European Journal of Obstetrics and Gynecology and Reproductive Biology: X Pub Date : 2025-05-01 DOI:10.1016/j.eurox.2025.100393

Chatuporn Duangkum , Suphawan Pattamathamakul , Sukanya Chaiyarach , Piyamas Saksiriwuttho , Jen Sothornwit , Pongsatorn Paopongsawan , Kittisak Sawanyawisuth , Sathida Chantanaviliai , Manasicha Pongsamakthai

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引用次数: 0

摘要

目的对妊娠34 0/7 ~ 36 6/7周间的早产胎膜破裂（PPROM）进行准产治疗。尽管PPROM的预期分娩是合理的，但在现实环境中，预测PPROM分娩>； 48小时的数据有限。因此，本研究旨在寻找PPROM妇女分娩>； 48小时的临床预测因素以及临床实践中的临床结局。材料和方法本研究是在两家三级医院进行的回顾性队列研究。纳入标准为单胎妊娠伴PPROM和计划待产管理。临床数据从医院的数据库中检索。符合条件的孕妇被分为两组：PPROM分娩<； 48小时或PPROM分娩>； 48小时。主要结局是预测PPROM发生的因素>； 48小时。结果在研究期间，519名孕妇符合研究标准。其中90例孕妇（17.34 %）发生PPROM分娩>； 48小时。与PPROM分娩>； 48小时独立相关的因素是产妇年龄≥ 19岁（调整优势比[aOR] 0.95, 95 % CI[0.91, 0.99]）和羊水过少（aOR 2.41, 95 % CI[1.45, 4.00]）。关于产妇和新生儿结局，PPROM分娩>； 48小时组新生儿出生体重较低(2245 g vs. 2490 g；p <； 0.001)比PPROM交付<； 48小时组。然而，新生儿结局，包括呼吸窘迫、败血症、新生儿重症监护病房入院、早期黄疸、低血糖、正压通气和早期呼吸支持，没有差异。结论在现实世界中分娩PPROM >； 48小时的临床预测因素是产妇年龄和羊水过少。PPROM分娩>； 48小时与PPROM分娩<； 48小时的产妇和新生儿结局几乎相当。PPROM交付>； 48小时可能是安全的，可以作为PPROM的治疗选择。然而，由于本研究是在泰国三级医院回顾性进行的，因此可能需要进一步的研究来推广。

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Predictors of delivery at 48 hours or more in pregnant women with preterm prelabor rupture of membrane: A retrospective cohort study

Objective

Expectant management is an option for preterm prelabor rupture of the membrane (PPROM) between 34 0/7 and 36 6/7 weeks of gestation. Even though expectant delivery in PPROM is justified, there is limited data on predictors of PPROM delivered > 48 hrs in a real-world setting. Therefore, this study aimed to find clinical predictors for delivery > 48 hrs in women with PPROM as well as clinical outcomes in clinical practice.

Materials and methods

This was a retrospective cohort study conducted at two tertiary care hospitals. The inclusion criteria were a singleton pregnancy with PPROM and planned expectant management. Clinical data were retrieved from the hospitals’ databases. Eligible pregnant women were categorized into two groups: PPROM delivered < 48 hrs or PPROM delivered > 48 hrs. The primary outcome was factors predictive of PPROM delivered > 48 hrs.

Results

During the study period, 519 pregnant women met the study criteria. Of those, 90 pregnant women (17.34 %) had PPROM delivered > 48 hrs. Factors independently associated with PPROM delivered > 48 hrs were maternal age ≥ 19 years (adjusted odds ratio [aOR] 0.95, 95 % CI [0.91, 0.99]) and oligohydramnios (aOR 2.41, 95 % CI [1.45, 4.00]). Regarding maternal and neonatal outcomes, the PPROM delivered > 48 hrs group had lower neonatal birth weights (2245 g vs. 2490 g; p < 0.001) than the PPROM delivered < 48 hrs group. However, neonatal outcomes, including respiratory distress, sepsis, neonatal intensive care unit admission, early jaundice, hypoglycemia, positive pressure ventilation, and early respiratory support, were not different.

Conclusions

Clinical predictors for PPROM delivered > 48 hrs in a real-world setting were maternal age and presence of oligohydramnios. Maternal and neonatal outcomes in the PPROM delivered > 48 hrs were almost comparable with the PPROM delivered < 48 hrs. PPROM delivered > 48 hrs may be safe and can be a treatment option for PPROM. However, further studies may be required in terms of generalizability as this study was conducted retrospectively in tertiary care hospitals in Thailand.

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