Aziz Natali, Cheng Yvonne W, Caughey Aaron B
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco, San Francisco, California, USA.
J Matern Fetal Neonatal Med. 2008 Nov;21(11):821-5. doi: 10.1080/14767050802251255.
To examine factors and outcomes associated with latency in preterm premature rupture of membranes (PPROM).
A retrospective cohort study was conducted of all deliveries with a diagnosis of PPROM at 24-34 weeks of gestation at an academic medical center for the period 1980-2001. Gestational age at PPROM was examined as the primary independent variable. Primary outcome was duration from rupture of membranes until delivery. The association with neonatal and maternal perinatal morbidity was examined with duration of latency. Dichotomous outcomes were compared using the Chi-square test. Multivariable regression analyses were performed to control for potential confounding variables.
One thousand one hundred and sixty-eight patients were identified. Latency duration was inversely associated with gestational age at time of PPROM (p < 0.001). These findings persisted when potential confounders were controlled for in multivariable models. Neonatal sepsis and chorioamnionitis were not associated with increased duration of latency.
Earlier gestational age at time of PPROM is associated with longer latency duration, which, in turn, is not associated with increased neonatal sepsis or chorioamnionitis. These data can be used to counsel patients with PPROM about expected duration of latency and outcomes.
探讨与早产胎膜早破(PPROM)潜伏期相关的因素及结局。
对1980 - 2001年期间在一所学术性医疗中心诊断为孕24 - 34周PPROM的所有分娩病例进行回顾性队列研究。将PPROM时的孕周作为主要自变量进行研究。主要结局是从胎膜破裂至分娩的持续时间。研究潜伏期与新生儿及孕产妇围产期发病率的相关性。二分结局采用卡方检验进行比较。进行多变量回归分析以控制潜在的混杂变量。
共纳入1168例患者。潜伏期与PPROM时的孕周呈负相关(p < 0.001)。在多变量模型中控制潜在混杂因素后,这些结果依然成立。新生儿败血症和绒毛膜羊膜炎与潜伏期延长无关。
PPROM时孕周越早,潜伏期越长,而潜伏期延长与新生儿败血症或绒毛膜羊膜炎增加无关。这些数据可用于为PPROM患者提供关于预期潜伏期及结局的咨询。