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Late preterm delivery in women with preterm prelabour rupture of membranes.
J Obstet Gynaecol Can. 2010 Jun; 32(6):555-560.JO

Abstract

OBJECTIVE

To estimate maternal and neonatal outcomes in women with preterm prelabour rupture of membranes (PPROM) who delivered at 34+0 to 36+6 weeks' gestation, particularly in those who had an obstetrically indicated delivery.

METHODS

We conducted a population-based study of late preterm singleton births complicated by PPROM, using data from the Nova Scotia Atlee Perinatal Database from 1988 to 2006. The study cohort was categorized by type of labour (spontaneous, induced, no labour), and each group's characteristics prior to delivery, and their outcomes were compared after accounting for potential confounding variables.

RESULTS

From a total population of 164 384 pregnancies, 2618 deliveries were identified as having PPROM. Among these, 2180 (83.3%) delivered between 34+0 and 36+6 weeks' gestation. Adjusted analyses showed no differences in risk between those women entering labour spontaneously (n = 1296) and those with obstetrically indicated delivery (labour induction or Caesarean section without labour, n = 698). Additional adjusted analyses evaluating only women with obstetrically indicated delivery showed that rates of chorioamnionitis (OR 0.27; 95% CI 0.08 to 0.93), composite perinatal morbidity/mortality (OR 0.39; 95% CI 0.25 to 0.62), neonatal depression at birth (OR 0.22; 95% CI 0.06 to 0.86), and respiratory distress syndrome (OR 0.17; 95% CI 0.06 to 0.47) were significantly lower in those delivering at 36 weeks (n = 458) than in those delivering at 34 to 35 weeks (n = 240).

CONCLUSIONS

This large population-based study suggests that in pregnancies complicated by PPROM rates of adverse maternal and perinatal outcomes at 36 weeks' gestational age are at least comparable to those in pregnancies delivering at 34 to 35 weeks, and these rates may be further reduced by delivery after 36 completed weeks if spontaneous labour has not occurred.

Authors+Show Affiliations

Faculty of Medicine, Dalhousie University, Halifax NS.Faculty of Medicine, Dalhousie University, Halifax NS; Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS.Faculty of Medicine, Dalhousie University, Halifax NS; Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS.Faculty of Medicine, Dalhousie University, Halifax NS; Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS; Department of Pediatrics, Dalhousie University, Halifax NS; Perinatal Epidemiology Research Unit, Dalhousie University, Halifax NS.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20569536

Citation

Lim, Jenny J Y., et al. "Late Preterm Delivery in Women With Preterm Prelabour Rupture of Membranes." Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstetrique Et Gynecologie Du Canada : JOGC, vol. 32, no. 6, 2010, pp. 555-560.
Lim JJY, Allen VM, Scott HM, et al. Late preterm delivery in women with preterm prelabour rupture of membranes. J Obstet Gynaecol Can. 2010;32(6):555-560.
Lim, J. J. Y., Allen, V. M., Scott, H. M., & Allen, A. C. (2010). Late preterm delivery in women with preterm prelabour rupture of membranes. Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstetrique Et Gynecologie Du Canada : JOGC, 32(6), 555-560. https://doi.org/10.1016/S1701-2163(16)34524-8
Lim JJY, et al. Late Preterm Delivery in Women With Preterm Prelabour Rupture of Membranes. J Obstet Gynaecol Can. 2010;32(6):555-560. PubMed PMID: 20569536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Late preterm delivery in women with preterm prelabour rupture of membranes. AU - Lim,Jenny J Y, AU - Allen,Victoria M, AU - Scott,Heather M, AU - Allen,Alexander C, PY - 2010/6/24/entrez PY - 2010/6/24/pubmed PY - 2010/9/30/medline SP - 555 EP - 560 JF - Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC JO - J Obstet Gynaecol Can VL - 32 IS - 6 N2 - OBJECTIVE: To estimate maternal and neonatal outcomes in women with preterm prelabour rupture of membranes (PPROM) who delivered at 34+0 to 36+6 weeks' gestation, particularly in those who had an obstetrically indicated delivery. METHODS: We conducted a population-based study of late preterm singleton births complicated by PPROM, using data from the Nova Scotia Atlee Perinatal Database from 1988 to 2006. The study cohort was categorized by type of labour (spontaneous, induced, no labour), and each group's characteristics prior to delivery, and their outcomes were compared after accounting for potential confounding variables. RESULTS: From a total population of 164 384 pregnancies, 2618 deliveries were identified as having PPROM. Among these, 2180 (83.3%) delivered between 34+0 and 36+6 weeks' gestation. Adjusted analyses showed no differences in risk between those women entering labour spontaneously (n = 1296) and those with obstetrically indicated delivery (labour induction or Caesarean section without labour, n = 698). Additional adjusted analyses evaluating only women with obstetrically indicated delivery showed that rates of chorioamnionitis (OR 0.27; 95% CI 0.08 to 0.93), composite perinatal morbidity/mortality (OR 0.39; 95% CI 0.25 to 0.62), neonatal depression at birth (OR 0.22; 95% CI 0.06 to 0.86), and respiratory distress syndrome (OR 0.17; 95% CI 0.06 to 0.47) were significantly lower in those delivering at 36 weeks (n = 458) than in those delivering at 34 to 35 weeks (n = 240). CONCLUSIONS: This large population-based study suggests that in pregnancies complicated by PPROM rates of adverse maternal and perinatal outcomes at 36 weeks' gestational age are at least comparable to those in pregnancies delivering at 34 to 35 weeks, and these rates may be further reduced by delivery after 36 completed weeks if spontaneous labour has not occurred. SN - 1701-2163 UR - https://www.unboundmedicine.com/medline/citation/20569536/Late_preterm_delivery_in_women_with_preterm_prelabour_rupture_of_membranes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1701-2163(16)34524-8 DB - PRIME DP - Unbound Medicine ER -