Hincu Maura-Adelina, Gheorghe Liliana, Paduraru Luminita, Dimitriu Daniela-Cristina, Harabor Anamaria, Vasilache Ingrid-Andrada, Solomon-Condriuc Iustina, Carauleanu Alexandru, Scripcariu Ioana Sadiye, Nemescu Dragos
Department of Mother and Child Care, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
Surgical Department, Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
Diagnostics (Basel). 2025 Jan 18;15(2):213. doi: 10.3390/diagnostics15020213.
: Prolonged prelabour rupture of membranes (PROMs), and the resulting inflammatory response, can contribute to the occurrence of adverse neonatal outcomes, especially for early-preterm neonates. This prospective study aimed to measure neonates' inflammatory markers in the first 72 h of life based on ROM duration. The second aim was to examine the relationship between PROMs, serum inflammatory markers, and composite adverse neonatal outcomes after controlling for gestational age (GA). : Data from 1026 patients were analyzed considering the following groups: group 1 (ROM < 18 h, = 447 patients) and group 2 (ROM > 18 h, = 579 patients). These groups were further segregated depending on the GA at the moment of membranes' rupture into subgroup 1 (<33 weeks of gestation and 6 days, = 168 patients) and subgroup 2 (at least 34 completed weeks of gestation, = 858 patients). Multiple logistic regressions and interaction analyses adjusted for GA considering five composite adverse neonatal outcomes and predictors were employed. : PROMs and high c-reactive protein (CRP) values significantly increased the risk of composite outcome 1 occurrence by 14% (95%CI: 1.03-1.57, < 0.001). PROMs and high CRP values increased the risk of composite outcome 5 by 14% (95%CI: 1.07-1.78, < 0.001), PROM and leukocytosis by 11% (95%CI: 1.02-1.59, = 0.001), and PROMs and high PCT values by 21% (95%CI: 1.04-2.10, < 0.001). : The combination of PROMs and high CRP values significantly increased the risk of all evaluated adverse composite outcomes in early-preterm neonates and should point to careful monitoring of these patients.
产前胎膜早破（PROMs）及其引发的炎症反应，可能会导致不良新生儿结局的发生，尤其是对于极早早产儿。这项前瞻性研究旨在根据胎膜破裂时间（ROM）来测量新生儿出生后72小时内的炎症标志物。第二个目的是在控制孕周（GA）后，研究PROMs、血清炎症标志物与综合不良新生儿结局之间的关系。：对1026例患者的数据进行了分析，分为以下几组：第1组（ROM＜18小时，n = 447例患者）和第2组（ROM＞18小时，n = 579例患者）。这些组再根据胎膜破裂时的孕周进一步分为亚组1（孕周＜33周6天，n = 168例患者）和亚组2（至少34个完整孕周，n = 858例患者）。采用多因素logistic回归和交互分析，对考虑五种综合不良新生儿结局和预测因素的GA进行调整。：PROMs和高C反应蛋白（CRP）值使综合结局1发生风险显著增加14%（95%CI：1.03 - 1.57，P＜0.001）。PROMs和高CRP值使综合结局5发生风险增加14%（95%CI：1.07 - 1.78，P＜0.001），PROMs和白细胞增多使风险增加11%（95%CI：1.02 - 1.59，P = 0.001），PROMs和高降钙素原（PCT）值使风险增加21%（95%CI：1.04 - 2.10，P＜0.001）。：PROMs和高CRP值的联合显著增加了极早早产儿所有评估的不良综合结局的风险，应对这些患者进行密切监测。
