国际多中心足月胎膜早破研究：足月胎膜早破患者所生婴儿新生儿感染预测因素的评估。胎膜早破

International multicenter term PROM study: evaluation of predictors of neonatal infection in infants born to patients with premature rupture of membranes at term. Premature Rupture of the Membranes.

作者信息

Seaward P G, Hannah M E, Myhr T L, Farine D, Ohlsson A, Wang E E, Hodnett E, Haque K, Weston J A, Ohel G

机构信息

Department of Obstetrics and Gynecology, Centre for Research in Women's Health, and University of Toronto, Ontario, Canada.

出版信息

Am J Obstet Gynecol. 1998 Sep;179(3 Pt 1):635-9. doi: 10.1016/s0002-9378(98)70056-0.

DOI:10.1016/s0002-9378(98)70056-0

PMID:9757963

Abstract

OBJECTIVE

Our objective was to determine significant predictors for the development of neonatal infection in infants born to patients with premature rupture of membranes at term.

STUDY DESIGN

Multivariate analysis was used to determine the significant predictors of neonatal infection in infants born to women with premature rupture of the membranes who were enrolled in the Term PROM Study. In a randomized, controlled trial, the Term PROM Study recently compared induction of labor with expectant management for premature rupture of membranes at term.

RESULTS

The following variables were identified as independent predictors of neonatal infection: clinical chorioamnionitis (odds ratio 5.89, P < .0001), positive maternal group B streptococcal status (vs negative or unknown, odds ratio 3.08, P < .0001), 7 to 8 vaginal digital examinations (vs 0 to 2, odds ratio 2.37, P = .04), 24 to < 48 hours from membrane rupture to active labor (vs < 12 hours, odds ratio 1.97, P = .02), > or = 48 hours from membrane rupture to active labor (vs < 12 hours, odds ratio 2.25, P = .01), and maternal antibiotics before delivery (odds ratio 1.63, P = .05).

CONCLUSIONS

Among infants born to patients with premature rupture of membranes at term, clinical chorioamnionitis and maternal colonization with group B streptococci are the most important predictors of subsequent neonatal infection.

摘要

目的

我们的目的是确定足月胎膜早破患者所生婴儿发生新生儿感染的重要预测因素。

研究设计

采用多变量分析来确定参与足月胎膜早破研究的胎膜早破女性所生婴儿发生新生儿感染的重要预测因素。在一项随机对照试验中，足月胎膜早破研究最近比较了足月胎膜早破引产与期待治疗的效果。

结果

以下变量被确定为新生儿感染的独立预测因素：临床绒毛膜羊膜炎（比值比5.89，P <.0001）、孕妇B族链球菌阳性状态（与阴性或未知相比，比值比3.08，P <.0001）、7至8次阴道指检（与0至2次相比，比值比2.37，P = .04）、胎膜破裂至活跃分娩24至<48小时（与<12小时相比，比值比1.97，P = .02）、胎膜破裂至活跃分娩≥48小时（与<12小时相比，比值比2.25，P = .01）以及产前使用母体抗生素（比值比1.63，P = .05）。