1
|
Sire F, Ponthier L, Eyraud JL, Catalan C, Aubard Y, Coste Mazeau P. Comparative study of dinoprostone and misoprostol for induction of labor in patients with premature rupture of membranes after 35 weeks. Sci Rep 2022; 12:14996. [PMID: 36056056 PMCID: PMC9439998 DOI: 10.1038/s41598-022-18948-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 08/22/2022] [Indexed: 11/23/2022] Open
Abstract
The modalities of induction of labor in the event of premature rupture of membranes are controversial. The main purpose of this study was to compare the modalities of delivery after the use of dinoprostone or misoprostol for labor induction in the preterm rupture of membranes after 35 weeks in women with an unfavorable cervix. We then studied maternal and fetal morbidity for the two drugs. Retrospective, single-center, comparative cohort study in a level 3 maternity unit in France from 2009 to 2018 comparing vaginal administration of misoprostol 50 µg every six hours (maximum 150 µg) and administration of dinoprostone 10 mg, a slow-release vaginal insert, for 24 h (maximum 20 mg), for labor induction in the preterm rupture of membranes after 35 weeks in women with an unfavorable cervix (Bishop score < 6). We included 904 patients, 656 in the misoprostol group and 248 in the dinoprostone group. Vaginal delivery rate was significantly higher in the dinoprostone group (89% vs. 82%, p = 0.016). There were more cesarean sections for abnormal fetal heart rate in the misoprostol group (p = 0.005). The time interval from induction to the beginning of the active phase of labor and the duration of labor were shorter in the misoprostol group than in the dinoprostone group (437 min vs. 719 min, p < 0.001 and 335 min vs. 381 min, p = 0.0023, respectively). Maternal and neonatal outcomes were not significantly different in the two groups. Vaginal dinoprostone used for labor induction in preterm rupture of membranes seems to be more effective for vaginal delivery than vaginal misoprostol (50 µg).
Collapse
Affiliation(s)
- Flavie Sire
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospital, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - Laure Ponthier
- Department of Pediatrics, Mother and Children's Hospital, Limoges Regional University Hospital, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - Jean-Luc Eyraud
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospital, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - Cyrille Catalan
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospital, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - Yves Aubard
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospital, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - Perrine Coste Mazeau
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospital, 8 Avenue Dominique Larrey, 87000, Limoges, France.
- Centre de Biologie et de Recherche en Santé, CHRU Limoges, Université de Limoges, Inserm U1092, 2 rue du Pr Bernard Descottes, 87000, Limoges, France.
| |
Collapse
|
2
|
Lorthe E, Kayem G. Tocolysis in the management of preterm prelabor rupture of membranes at 22-33 weeks of gestation: study protocol for a multicenter, double-blind, randomized controlled trial comparing nifedipine with placebo (TOCOPROM). BMC Pregnancy Childbirth 2021; 21:614. [PMID: 34496799 PMCID: PMC8425321 DOI: 10.1186/s12884-021-04047-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/12/2021] [Indexed: 11/17/2022] Open
Abstract
Background Preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation complicates 1% of pregnancies and accounts for one-third of preterm births. International guidelines recommend expectant management, along with antenatal steroids before 34 weeks and antibiotics. Up-to-date evidence about the risks and benefits of administering tocolysis after PPROM, however, is lacking. In theory, reducing uterine contractility could delay delivery and reduce the risks of prematurity and its adverse short- and long-term consequences, but it might also prolong fetal exposure to inflammation, infection, and acute obstetric complications, potentially associated with neonatal death or long-term sequelae. The primary objective of this study is to assess whether short-term (48 h) tocolysis reduces perinatal mortality/morbidity in PPROM at 22 to 33 completed weeks of gestation. Methods A randomized, double-blind, placebo-controlled, superiority trial will be performed in 29 French maternity units. Women with PPROM between 220/7 and 336/7 weeks of gestation, a singleton pregnancy, and no condition contraindicating expectant management will be randomized to receive a 48-hour oral treatment by either nifedipine or placebo (1:1 ratio). The primary outcome will be the occurrence of perinatal mortality/morbidity, a composite outcome including fetal death, neonatal death, or severe neonatal morbidity before discharge. If we assume an alpha-risk of 0.05 and beta-risk of 0.20 (i.e., a statistical power of 80%), 702 women (351 per arm) are required to show a reduction of the primary endpoint from 35% (placebo group) to 25% (nifedipine group). We plan to increase the required number of subjects by 20%, to replace any patients who leave the study early. The total number of subjects required is thus 850. Data will be analyzed by the intention-to-treat principle. Discussion This trial will inform practices and policies worldwide. Optimized prenatal management to improve the prognosis of infants born preterm could benefit about 50,000 women in the European Union and 40,000 in the United States each year. Trial registration ClinicalTrials.gov identifier: NCT03976063 (registration date June 5, 2019). Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04047-2.
Collapse
Affiliation(s)
- Elsa Lorthe
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004, Paris, France.,Unit of Population Epidemiology, Department of Primary Care Medicine, Geneva University Hospitals, 1205, Geneva, Switzerland
| | - Gilles Kayem
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004, Paris, France. .,Department of Gynecology and Obstetrics, Trousseau Hospital, APHP, FHU Prema, Sorbonne University, Paris, France.
| | | |
Collapse
|
3
|
Unit policies regarding tocolysis after preterm premature rupture of membranes: association with latency, neonatal and 2-year outcomes (EPICE cohort). Sci Rep 2020; 10:9535. [PMID: 32533019 PMCID: PMC7293322 DOI: 10.1038/s41598-020-65201-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 04/29/2020] [Indexed: 11/09/2022] Open
Abstract
After preterm premature rupture of membranes (PPROM), antibiotics and antenatal steroids are effective evidence-based interventions, but the use of tocolysis is controversial. We investigated whether a unit policy of tocolysis use after PPROM is associated with prolonged gestation and improved outcomes for very preterm infants in units that systematically use these other evidence-based treatments. From the prospective, observational, population-based EPICE cohort study (all very preterm births in 19 regions from 11 European countries, 2011-2012), we included 607 women with a singleton pregnancy and PPROM at 24-29 weeks' gestation, of whom 101, 195 and 311 were respectively managed in 17, 32 and 45 units with no-use, restricted and liberal tocolysis policies for PPROM. The association between unit policies and outcomes (early-onset sepsis, survival at discharge, survival at discharge without severe morbidity and survival at two years without gross motor impairment) was investigated using three-level random-intercept logistic regression models, showing no differences in neonatal or two-year outcomes by unit policy. Moreover, there was no association between unit policies and prolongation of gestation in a multilevel survival analysis. Compared to a unit policy of no-use of tocolysis after PPROM, a liberal or restricted policy is not associated with improved obstetric, neonatal or two-year outcomes.
Collapse
|
4
|
Merello M, Lotte L, Gonfrier S, Eleni Dit Trolli S, Casagrande F, Ruimy R, Bongain A. Enterobacteria vaginal colonization among patients with preterm premature rupture of membranes from 24 to 34 weeks of gestation and neonatal infection risk. J Gynecol Obstet Hum Reprod 2018; 48:187-191. [PMID: 30562580 DOI: 10.1016/j.jogoh.2018.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/06/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022]
Abstract
AIM Premature rupture of membranes (PROM) increases the neonatal morbidity and mortality, because of its association with a high risk of prematurity and infection. The group B streptococcus (GBS) prophylaxis using amoxicillin doesn't seem to be adapted to the emergence of new bacteria found in vaginal samples (VS). Our study aim was to assess, for PROM occurring at 23-34 weeks' gestation (WG), if the presence of ampicillin-resistant enterobacteria in the vaginal microbiome is predictive of an increased risk of early-onset neonatal infection. MATERIAL AND METHODS We conducted a prospective, observational, single-center study at the Nice Academic Hospital (level 3 maternity ward), between March 16, 2014 and May 3, 2015, that evaluated patients with preterm PROM (24-34 WG). Two groups were constituted according to the VS bacteria isolates and the amoxycillin-resistant enterobacteria found. Two groups of newborns were constituted depending on the suspicion of perinatal maternal-fetal bacterial infection (MFI). An intent-to-treat analysis was performed. RESULTS Among the 67 patients included, 12 newborns presented a strong MFI suspicion, 83% of which were associated to the group of patients with untreated or amoxycillin-resistant enterobacteria VS isolates. CONCLUSION Our study showed that vaginal colonization of untreated or amoxycillin-resistant enterobacteria constitutes a major risk factor of neonatal infection.
Collapse
Affiliation(s)
- Marion Merello
- Department of Obstetrics and Gynecology at Nice Academic Hospital, France; Department of Geriatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France.
| | - Laurène Lotte
- Department of Bacteriology at Nice Academic Hospital, France; Department of Geriatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - Sébastien Gonfrier
- Department of Geriatrics at Nice Academic Hospital, France; Department of Pediatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - Sergio Eleni Dit Trolli
- Department of Geriatrics at Nice Academic Hospital, France; Department of Pediatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - Florence Casagrande
- Department of Geriatrics at Nice Academic Hospital, France; Department of Pediatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - Raymond Ruimy
- Department of Bacteriology at Nice Academic Hospital, France; Department of Geriatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - André Bongain
- Department of Obstetrics and Gynecology at Nice Academic Hospital, France; Department of Geriatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| |
Collapse
|
5
|
Pasquier JC, Claris O, Rabilloud M, Ecochard R, Picaud JC, Moret S, Buch D, Mellier G. Intentional early delivery versus expectant management for preterm premature rupture of membranes at 28-32 weeks' gestation: A multicentre randomized controlled trial (MICADO STUDY). Eur J Obstet Gynecol Reprod Biol 2018; 233:30-37. [PMID: 30553135 DOI: 10.1016/j.ejogrb.2018.11.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/17/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Preterm premature rupture of fetal membranes (PPROM) exposes the fetus to preterm birth, and optimal timing for delivery is controversial. The aim of this study was to compare intentional early delivery ("active management") with expectant management in very preterm birth (28-32 weeks). STUDY DESIGN We conducted a prospective randomized controlled trial with intent-to-treat analysis, at 19 tertiary-care hospitals in France and 1 in Geneva, Switzerland. Inclusion criteria were women age ≥18 years, PPROM at 280/7 to 316/7 weeks' gestation, singleton pregnancy. Exclusion criteria were maternal/fetal indications for immediate delivery. All participants received prophylactic antibiotics (amoxicillin + gentamicin) and two doses of corticosteroids. Women in expectant management delivered at 34 weeks, sooner if medically indicated. Women in active management delivered 24 h after the second steroid dose. The primary outcome measure was a composite of neonatal death/severe adverse events: periventricular leukomalacia, intraventricular hemorrhage, sepsis, oxygen requirement at 36 weeks, and necrotizing enterocolitis. The secondary outcome was clinical chorioamnionitis. RESULTS The trial was stopped prematurely, due to recruitment difficulties. Of 360 women assessed, 139 (40% of calculated sample size) were randomized: 70 to expectant management, 69 to active management. Mean gestational age at PPROM was similar in both groups (30 ± 1.3 vs. 30.2 ± 1.2 weeks, respectively). There were 35 cases of medical/suspected complications requiring delivery in expectant management vs. 4 in active management. Mean latency between PPROM and delivery was 11.7 ± 9.8 vs. 2.8 ± 0.6 days, respectively; P < 0.0001 (median 8.4 (1.8-44.2) vs. 2.7 (1.9-4.3)). There were more caesarean deliveries in active than expectant management (80% vs. 60%, respectively; P < 0.01). There were 2 chorioamnionitis cases, both in expectant management. One baby died in expectant management; 2 in active management (one with heart defect). There was no significant difference in sepsis rates. The combined neonatal death/severe adverse events measure was 12.9% for expectant management and 13.0% for active management (OR 0.98; 95% CI: 0.33-2.93, P = 0.97). CONCLUSION For PPROM at 28-32 weeks, and with antenatal antibiotic and steroid therapy, there were no observed differences in neonatal health when comparing expectant management to early delivery. As expected, expectant management resulted in higher gestational age and birth weight. However, our study was underpowered to draw firm and reliable conclusions.
Collapse
Affiliation(s)
- Jean-Charles Pasquier
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Faculté de médecine et des sciences de la santé 3001, 12e avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
| | - Olivier Claris
- Department of Neonatology, Hôpital Famille Mère Enfant, Hospices Civils de Lyon, Lyon, France
| | | | - René Ecochard
- Service de Biostatistique, Hospices Civils de Lyon, France
| | - Jean-Charles Picaud
- Department of Neonatology, Hôpital de la Croix Rousse, Hospices Civils de Lyon, and Université de Lyon, Lyon, France
| | - Stéphanie Moret
- Department of Obstetrics and Gynecology, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France
| | - Danielle Buch
- Faculté des études supérieures et postdoctorales, Université de Montréal, Montreal, Quebec, Canada
| | - Georges Mellier
- Department of Obstetrics and Gynecology, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
6
|
Lorthe E, Goffinet F, Marret S, Vayssiere C, Flamant C, Quere M, Benhammou V, Ancel PY, Kayem G. Tocolysis after preterm premature rupture of membranes and neonatal outcome: a propensity-score analysis. Am J Obstet Gynecol 2017; 217:212.e1-212.e12. [PMID: 28412086 DOI: 10.1016/j.ajog.2017.04.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/29/2017] [Accepted: 04/05/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND There are conflicting results regarding tocolysis in cases of preterm premature rupture of membranes. Delaying delivery may reduce neonatal morbidity because of prematurity and allow for prenatal corticosteroids and, if necessary, in utero transfer. However, that may increase the risks of maternofetal infection and its adverse consequences. OBJECTIVE The objective of the study was to investigate whether tocolytic therapy in cases of preterm premature rupture of membranes is associated with improved neonatal or obstetric outcomes. STUDY DESIGN Etude Epidémiologique sur les Petits Ages Gestationnels 2 is a French national prospective, population-based cohort study of preterm births that occurred in 546 maternity units in 2011. Inclusion criteria in this analysis were women with preterm premature rupture of membranes at 24-32 weeks' gestation and singleton gestations. Outcomes were survival to discharge without severe morbidity, latency prolonged by ≥48 hours and histological chorioamnionitis. Uterine contractions at admission, individual and obstetric characteristics, and neonatal outcomes were compared by tocolytic treatment or not. Propensity scores and inverse probability of treatment weighting for each woman were used to minimize indication bias in estimating the association of tocolytic therapy with outcomes. RESULTS The study population consisted of 803 women; 596 (73.4%) received tocolysis. Women with and without tocolysis did not differ in neonatal survival without severe morbidity (86.7% vs 83.9%, P = .39), latency prolonged by ≥48 hours (75.1% vs 77.4%, P = .59), or histological chorioamnionitis (50.0% vs 47.6%, P = .73). After applying propensity scores and assigning inverse probability of treatment weighting, tocolysis was not associated with improved survival without severe morbidity as compared with no tocolysis (odds ratio, 1.01 [95% confidence interval, 0.94-1.09], latency prolonged by ≥48 hours (1.03 [95% confidence interval, 0.95-1.11]), or histological chorioamnionitis (1.03 [95% confidence interval, 0.92-1.17]). There was no association between the initial tocolytic drug used (oxytocin receptor antagonists or calcium-channel blockers vs no tocolysis) and the 3 outcomes. Sensitivity analyses of women with preterm premature rupture of membranes at 26-31 weeks' gestation, women who delivered at least 12 hours after rupture of membranes, women with direct admission after the rupture of membranes and the presence or absence of contractions gave similar results. CONCLUSION Tocolysis in cases of preterm premature rupture of membranes is not associated with improved obstetric or neonatal outcomes; its clinical benefit remains unproven.
Collapse
Affiliation(s)
- Elsa Lorthe
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, and Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Sorbonne Universités, Université Pierre and Marie Curie, Institut de Formation Doctorale, Paris, France.
| | - François Goffinet
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, and Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Department of Obstetrics and Gynecology, Cochin, Broca, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Stéphane Marret
- Department of Neonatal Medicine, Rouen University Hospital and Région-Institut National de la Santé et de la Recherche Médicale (ERI 28), Normandy University, Rouen, France
| | - Christophe Vayssiere
- Department of Obstetrics and Gynecology, University Hospital, Toulouse, France; Research Unit on Perinatal Epidemiology, Childhood Disabilities, and Adolescent Health, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1027, Paul Sabatier University, Toulouse, France
| | - Cyril Flamant
- Department of Neonatal Medicine, Nantes University Hospital, Nantes, France
| | - Mathilde Quere
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, and Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Valérie Benhammou
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, and Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Pierre-Yves Ancel
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, and Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Unité de Recherche Clinique-Centre d'Investigations Cliniques P1419, Département Hospitalo-Universitaire Risks in Pregnancy, Cochin Hotel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gilles Kayem
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, and Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Sorbonne Universités, Université Pierre and Marie Curie, Institut de Formation Doctorale, Paris, France; Department of Obstetrics and Gynecology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| |
Collapse
|
7
|
Lorthe E, Ancel PY, Torchin H, Kaminski M, Langer B, Subtil D, Sentilhes L, Arnaud C, Carbonne B, Debillon T, Delorme P, D'Ercole C, Dreyfus M, Lebeaux C, Galimard JE, Vayssiere C, Winer N, L'Helias LF, Goffinet F, Kayem G. Impact of Latency Duration on the Prognosis of Preterm Infants after Preterm Premature Rupture of Membranes at 24 to 32 Weeks' Gestation: A National Population-Based Cohort Study. J Pediatr 2017; 182:47-52.e2. [PMID: 28081890 DOI: 10.1016/j.jpeds.2016.11.074] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/20/2016] [Accepted: 11/28/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess the impact of latency duration on survival, survival without severe morbidity, and early-onset sepsis in infants born after preterm premature rupture of membranes (PPROM) at 24-32 weeks' gestation. STUDY DESIGN This study was based on the prospective national population-based Etude Épidémiologique sur les Petits Ȃges Gestationnels 2 cohort of preterm births and included 702 singletons delivered in France after PPROM at 24-32 weeks' gestation. Latency duration was defined as the time from spontaneous rupture of membranes to delivery, divided into 4 periods (12 hours to 2 days [reference], 3-7 days, 8-14 days, and >14 days). Multivariable logistic regression was used to assess the relationship between latency duration and survival, survival without severe morbidity at discharge, or early-onset sepsis. RESULTS Latency duration ranged from 12 hours to 2 days (18%), 3-7 days (38%), 8-14 days (24%), and >14 days (20%). Rates of survival, survival without severe morbidity, and early-onset sepsis were 93.5% (95% CI 91.8-94.8), 85.4% (82.4-87.9), and 3.4% (2.0-5.7), respectively. A crude association found between prolonged latency duration and improved survival disappeared on adjusting for gestational age at birth (aOR 1.0 [reference], 1.6 [95% CI 0.8-3.2], 1.2 [0.5-2.9], and 1.0 [0.3-3.2] for latency durations from 12 hours to 2 days, 3-7 days, 8-14 days, and >14 days, respectively). Prolonged latency duration was not associated with survival without severe morbidity or early-onset sepsis. CONCLUSION For a given gestational age at birth, prolonged latency duration after PPROM does not worsen neonatal prognosis.
Collapse
Affiliation(s)
- Elsa Lorthe
- Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Sorbonne Universités, University Pierre and Marie Curie, Paris 06, Institut de Formation Doctorale, Paris, France.
| | - Pierre-Yves Ancel
- Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Unité de Recherche Clinique-Centre d'Investigations Cliniques P1419, Cochin Hotel-Dieu Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Héloïse Torchin
- Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Monique Kaminski
- Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Bruno Langer
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg, France
| | - Damien Subtil
- Department of Obstetrics and Gynecology, Jeanne de Flandre Hospital, Lille, France
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Catherine Arnaud
- Research Unit on Perinatal Epidemiology, Childhood Disabilities and Adolescent Health, Inserm UMR 1027, Paul Sabatier University, Toulouse, France
| | - Bruno Carbonne
- Department of Obstetrics and Gynecology, Princess Grace Hospital, Monaco
| | - Thierry Debillon
- Department of Neonatal Pediatrics, University Hospital, Grenoble, France
| | - Pierre Delorme
- Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Department of Obstetrics and Gynecology, Cochin, Broca, Hôtel Dieu Hospital, AP-HP, Paris, France
| | - Claude D'Ercole
- Department of Obstetrics and Gynecology, Nord Hospital, Assistance Publique des Hôpitaux de Marseille (AP-HM), Aix Marseille Université, Marseille, France
| | - Michel Dreyfus
- Department of Gynecology and Obstetrics, University Hospital, Caen, France
| | - Cécile Lebeaux
- Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Jacques-Emmanuel Galimard
- Department of Biostatistics and Medical Information (ECSTRA Team), Centre of Research in Epidemiology and Statistics Sorbonne, Inserm UMR 1153, Université Paris Diderot, Paris, France
| | - Christophe Vayssiere
- Research Unit on Perinatal Epidemiology, Childhood Disabilities and Adolescent Health, Inserm UMR 1027, Paul Sabatier University, Toulouse, France; Department of Obstetrics and Gynecology, University Hospital, Toulouse, France
| | - Norbert Winer
- Department of Obstetrics and Gynecology, University Hospital, National Institute for Agricultural Research, UMR 1280 Physiologie des adaptations nutritionnelles, Nantes, France
| | - Laurence Foix L'Helias
- Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Department of Neonatal Pediatrics, Trousseau Hospital, AP-HP, Paris, France
| | - François Goffinet
- Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Department of Obstetrics and Gynecology, Cochin, Broca, Hôtel Dieu Hospital, AP-HP, Paris, France
| | - Gilles Kayem
- Inserm Unité Mixte de Recherche (UMR) 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris Descartes University, Paris, France; Sorbonne Universités, University Pierre and Marie Curie, Paris 06, Institut de Formation Doctorale, Paris, France; Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France
| |
Collapse
|
8
|
Kayem G, Girard G. Gestion anténatale du risque d’infection amnio-choriale en cas de rupture prématurée des membranes avant 37 semaines d’aménorrhée. Arch Pediatr 2015; 22:1056-63. [DOI: 10.1016/j.arcped.2015.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 11/25/2014] [Accepted: 03/26/2015] [Indexed: 11/29/2022]
|
9
|
Gascoin G, Flamant C. Conséquences à long terme des enfants nés dans un contexte de retard de croissance intra-utérin et/ou petits pour l’âge gestationnel. ACTA ACUST UNITED AC 2013; 42:911-20. [DOI: 10.1016/j.jgyn.2013.09.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|