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J Pediatr. 2017 Mar;182:47-52.e2. doi: 10.1016/j.jpeds.2016.11.074. Epub 2017 Jan 9.

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.

Author information

1
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. Electronic address: elsa.lorthe@gmail.com.
2
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.
3
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.
4
Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg, France.
5
Department of Obstetrics and Gynecology, Jeanne de Flandre Hospital, Lille, France.
6
Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France.
7
Research Unit on Perinatal Epidemiology, Childhood Disabilities and Adolescent Health, Inserm UMR 1027, Paul Sabatier University, Toulouse, France.
8
Department of Obstetrics and Gynecology, Princess Grace Hospital, Monaco.
9
Department of Neonatal Pediatrics, University Hospital, Grenoble, France.
10
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.
11
Department of Obstetrics and Gynecology, Nord Hospital, Assistance Publique des Hôpitaux de Marseille (AP-HM), Aix Marseille Université, Marseille, France.
12
Department of Gynecology and Obstetrics, University Hospital, Caen, France.
13
Department of Biostatistics and Medical Information (ECSTRA Team), Centre of Research in Epidemiology and Statistics Sorbonne, Inserm UMR 1153, Université Paris Diderot, Paris, France.
14
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.
15
Department of Obstetrics and Gynecology, University Hospital, National Institute for Agricultural Research, UMR 1280 Physiologie des adaptations nutritionnelles, Nantes, France.
16
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.
17
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.

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.

KEYWORDS:

EPIPAGE 2; early-onset sepsis; expectant management; latency; perinatal outcome; prematurity; preterm premature rupture of membranes; survival

PMID:
28081890
DOI:
10.1016/j.jpeds.2016.11.074
[Indexed for MEDLINE]
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