BACKGROUND: One third of all preterm births are due to preterm premature rupture of membranes (pPROM). An accurate prognostic evaluation after admission to the neonatal intensive care unit is necessary. OBJECTIVE: The aim of this study was to identify prognostic factors within the first hour of life for mortality, short-term pulmonary morbidity, chronic lung disease (CLD) and severe cerebral morbidity in very low birth weight (VLBW) infants after pPROM. METHODS: This retrospective study included 300 infants with pPROM who fit the study criteria and were derived from a cohort of 1,435 VLBW infants. A total of 17 obstetric and neonatal factors were evaluated by univariate and multivariate analysis. RESULTS: Gestational age at birth and 5-min Apgar score correlated significantly with all 4 outcomes. The results of the first blood gas analysis correlated with 3 outcomes and the first mean arterial pressure with 2 outcomes. Anhydramnios and a lower number of courses of antenatal steroids correlated with higher mortality, and preterm labor correlated with CLD. The multivariate analysis revealed gestational age, 5-min Apgar score, the results of the first blood gas analysis, the first mean arterial pressure and anhydramnios to be significant predictors. The positive predictive value ranged from 20 to 81%, and the negative predictive value ranged from 79 to 92%. CONCLUSION: Gestational age at birth and parameters reflecting postnatal adaptation were the most precise factors for assessment of the prognosis of VLBW infants after pPROM within the first hour of life. Apart from anhydramnios, obstetric factors did not predict neonatal outcome. At 1 h of age, our models of perinatal risk factors were more effective in predicting a favorable outcome than an adverse outcome.
BACKGROUND: One third of all preterm births are due to preterm premature rupture of membranes (pPROM). An accurate prognostic evaluation after admission to the neonatal intensive care unit is necessary. OBJECTIVE: The aim of this study was to identify prognostic factors within the first hour of life for mortality, short-term pulmonary morbidity, chronic lung disease (CLD) and severe cerebral morbidity in very low birth weight (VLBW) infants after pPROM. METHODS: This retrospective study included 300 infants with pPROM who fit the study criteria and were derived from a cohort of 1,435 VLBW infants. A total of 17 obstetric and neonatal factors were evaluated by univariate and multivariate analysis. RESULTS: Gestational age at birth and 5-min Apgar score correlated significantly with all 4 outcomes. The results of the first blood gas analysis correlated with 3 outcomes and the first mean arterial pressure with 2 outcomes. Anhydramnios and a lower number of courses of antenatal steroids correlated with higher mortality, and preterm labor correlated with CLD. The multivariate analysis revealed gestational age, 5-min Apgar score, the results of the first blood gas analysis, the first mean arterial pressure and anhydramnios to be significant predictors. The positive predictive value ranged from 20 to 81%, and the negative predictive value ranged from 79 to 92%. CONCLUSION: Gestational age at birth and parameters reflecting postnatal adaptation were the most precise factors for assessment of the prognosis of VLBW infants after pPROM within the first hour of life. Apart from anhydramnios, obstetric factors did not predict neonatal outcome. At 1 h of age, our models of perinatal risk factors were more effective in predicting a favorable outcome than an adverse outcome.
Authors: Agnes Messerschmidt; Anna Pataraia; Hanns Helmer; Gregor Kasprian; Alexandra Sauer; Peter C Brugger; Arnold Pollak; Michael Weber; Daniela Prayer Journal: Pediatr Radiol Date: 2011-09-10
Authors: Kathrin Hanke; Annika Hartz; Maike Manz; Meike Bendiks; Friedhelm Heitmann; Thorsten Orlikowsky; Andreas Müller; Dirk Olbertz; Thomas Kühn; Jens Siegel; Axel von der Wense; Christian Wieg; Angela Kribs; Anja Stein; Julia Pagel; Egbert Herting; Wolfgang Göpel; Christoph Härtel Journal: PLoS One Date: 2015-04-09 Impact factor: 3.240
Authors: Wes Onland; Thomas P Debray; Matthew M Laughon; Martijn Miedema; Filip Cools; Lisa M Askie; Jeanette M Asselin; Sandra A Calvert; Sherry E Courtney; Carlo Dani; David J Durand; Neil Marlow; Janet L Peacock; J Jane Pillow; Roger F Soll; Ulrich H Thome; Patrick Truffert; Michael D Schreiber; Patrick Van Reempts; Valentina Vendettuoli; Giovanni Vento; Anton H van Kaam; Karel G Moons; Martin Offringa Journal: BMC Pediatr Date: 2013-12-17 Impact factor: 2.125