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Original Article

A predictive neonatal mortality score for women with premature rupture of membranes after 22–27 weeks of gestation

, , , , &
Pages 258-264 | Received 18 Jun 2017, Accepted 07 Sep 2017, Published online: 26 Sep 2017
 

Abstract

Objective: Premature rupture of the membranes (PROM) remains a leading cause of neonatal morbidity. The objectives of the present study were to analyze the outcomes of pregnancies complicated by PROM between 22 and 27+6 weeks of gestation (WG) and to study antepartum risk factors that might predict neonatal death.

Patients and methods: One hundred and seven pregnancies were analyzed over a 3-year period in a tertiary maternity hospital. The collected maternal and neonatal data were used to model and predict the outcome of PROM.

Results: Prevalence of PROM (for live births) was 1.08%, and the overall survival rate was 59.8%. From preselected candidate variables, gestational age (GA) at PROM (p = .0002), a positive vaginal culture for pathogenic bacteria (p = .01), primiparity (p = .02), and the quantity of amniotic fluid (p = .03) were included in a multivariable logistic regression analysis. The corresponding adjusted odds ratios [95% confidence interval] were, respectively, 0.91 [0.87–0.96], 11.08 [1.65–74.42], 0.55 [0.33–0.91], and 0.97 [0.95–0.99]. These parameters were used to build a predictive score for neonatal death.

Conclusions: The survival rate after PROM at 22–27+6 weeks of gestation was 59.8%. Our predictive model (built using multivariable logistic regression) may be of value for obstetricians and neonatologists counseling couples after PROM.

Acknowledgements

The authors thank Carl Picard and Jonathan Meynier for statistical analysis and David Fraser for copy-editing assistance.

Disclosure statement

None of the authors has any potential conflicts of interest. The authors alone are responsible for the content and writing of this article.

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