David P van der Ham1, Sander van Kuijk2, Brent C Opmeer3, Christine Willekes2, Johannes J van Beek4, Antonius L M Mulder5, Aren J van Loon6, Martiët Groenewout7, Gerald D Mantel8, Kitty W M Bloemenkamp9, Martina Porath10, Anneke Kwee11, Bettina M C Akerboom12, Dimitri N M Papatsonis13, Godfried C H Metz14, Jan G Nijhuis2, Ben W J Mol15. 1. Department of Obstetrics and Gynecology, Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, PO Box 5800, 6202 AZ Maastricht, The Netherlands; Department of Obstetrics and Gynecology, Martini Hospital Groningen, PO Box 30033, 9700 RB Groningen, The Netherlands. Electronic address: dpvanderham@gmail.com. 2. Department of Obstetrics and Gynecology, Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, PO Box 5800, 6202 AZ Maastricht, The Netherlands. 3. Clinical Research Unit, Academic Medical Centre Amsterdam, PO Box 22700, 1105 DE Amsterdam, The Netherlands. 4. Department of Obstetrics and Gynecology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, The Netherlands. 5. Department of Pediatrics, Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, PO Box 5800, 6202 AZ Maastricht, The Netherlands. 6. Department of Obstetrics and Gynecology, Martini Hospital Groningen, PO Box 30033, 9700 RB Groningen, The Netherlands. 7. Department of Obstetrics and Gynecology, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. 8. Department of Obstetrics and Gynecology, Isala Klinieken Zwolle, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands. 9. Department of Obstetrics and Gynecology, Leiden University Medical Centre, Albiniusdreef 2, 2333 ZA Leiden, The Netherlands. 10. Department of Obstetrics and Gynecology, Maxima Medical Centre Veldhoven, De Run 4600, 5504 DB Veldhoven, The Netherlands. 11. Department of Obstetrics and Gynecology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. 12. Department of Obstetrics and Gynecology, Albert Schweitzer Hospital Dordrecht, Albert Schweitzerplaats 25, 3318 AT Dordrecht, The Netherlands. 13. Department of Obstetrics and Gynecology, Amphia Hospital Breda, Langendijk 75, 4819 EV Breda, The Netherlands. 14. Department of Obstetrics and Gynecology, Ikazia Hospital Rotterdam, Montessoriweg 1, 3083 AN Rotterdam, The Netherlands. 15. Department of Obstetrics and Gynecology, School of Paediatrics and Reproductive Health, University of Adelaide, 5000 SA, Australia.
Abstract
OBJECTIVE:Women with late preterm premature rupture of membranes (PROM) have an increased risk that their child will develop neonatal sepsis. We evaluated whether neonatal sepsis can be predicted from antepartum parameters in these women. STUDY DESIGN: We used multivariable logistic regression to develop a prediction model. Data were obtained from two recent randomized controlled trials on induction of labor versus expectant management in late preterm PROM (PPROMEXIL trials, (ISRCTN29313500 and ISRCTN05689407). Data from randomized as well as non-randomized women, who consented to the use of their medical data, were used. We evaluated 13 potential antepartum predictors for neonatal sepsis. Missing data were imputed. Discriminative ability of the model was expressed as the area under the receiver operating characteristic (ROC) curve and a calibration with both a calibration plot and the Hosmer and Lemeshow goodness-of-fit test. Overall performance of the prediction model was quantified as the scaled Brier score. RESULTS: We studied 970 women. Thirty-three (3.4%) neonates suffered neonatal sepsis. Maternal age (OR 1.09 per year), maternal CRP level (OR 1.01 per mmol/l), maternal temperature (OR 1.80 per °C) and positive GBS culture (OR 2.20) were associated with an increased risk of neonatal sepsis. The model had an area under the ROC-curve of 0.71. The model had both a good calibration and accuracy. CONCLUSIONS: Antepartum parameters aid in the more precise prediction of the risk of neonatal sepsis in women with late preterm PPROM.
RCT Entities:
OBJECTIVE:Women with late preterm premature rupture of membranes (PROM) have an increased risk that their child will develop neonatal sepsis. We evaluated whether neonatal sepsis can be predicted from antepartum parameters in these women. STUDY DESIGN: We used multivariable logistic regression to develop a prediction model. Data were obtained from two recent randomized controlled trials on induction of labor versus expectant management in late preterm PROM (PPROMEXIL trials, (ISRCTN29313500 and ISRCTN05689407). Data from randomized as well as non-randomized women, who consented to the use of their medical data, were used. We evaluated 13 potential antepartum predictors for neonatal sepsis. Missing data were imputed. Discriminative ability of the model was expressed as the area under the receiver operating characteristic (ROC) curve and a calibration with both a calibration plot and the Hosmer and Lemeshow goodness-of-fit test. Overall performance of the prediction model was quantified as the scaled Brier score. RESULTS: We studied 970 women. Thirty-three (3.4%) neonates suffered neonatal sepsis. Maternal age (OR 1.09 per year), maternal CRP level (OR 1.01 per mmol/l), maternal temperature (OR 1.80 per °C) and positive GBS culture (OR 2.20) were associated with an increased risk of neonatal sepsis. The model had an area under the ROC-curve of 0.71. The model had both a good calibration and accuracy. CONCLUSIONS: Antepartum parameters aid in the more precise prediction of the risk of neonatal sepsis in women with late preterm PPROM.
Authors: Anna Niesłuchowska-Hoxha; Wojciech Cnota; Bartosz Czuba; Aleksandra Ruci; Magdalena Ciaciura-Jarno; Agnieszka Jagielska; Dominik Wójtowicz; Rafał Kierach; Krzysztof Dąbrowski; Marcin Sidorowicz; Wioletta Skrzypulec-Plinta; Agata Wloch; Dariusz Borowski; Piotr Węgrzyn Journal: Biomed Res Int Date: 2018-10-04 Impact factor: 3.411