TITLE:
Three-Year Outcome of Very Low Birth Weight Infants in Conservatively Managed Premature Rupture of Membranes
AUTHORS:
Jun Sasahara, Keisuke Ishii, Toshiko Kishimoto, Akiko Yamashita, Shusaku Hayashi, Nobuaki Mitsuda
KEYWORDS:
Preterm Rupture of Membranes, Conservative Treatment, Neonatal Outcome
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.1,
January
23,
2015
ABSTRACT:
Aim: To elucidate the outcome for very
low birth weight infants delivered after preterm premature rupture of membranes
(PPROM) managed conservatively, and to determine the prognostic value of
perinatal factors for long-term outcome. Methods: Perinatal data were collected
from medical records for singleton live-birth infants delivered between 1991
and 2008 after conservatively managed PPROM. Cases of congenital anomalies and
chromosomal aberrations were excluded. Poor outcome was defined as a composite
measure of death, neurological morbidity including cerebral palsy, or
neurodevelopmental delay. Associations between perinatal factors and poor
outcome at the corrected age of 3 were estimated using logistic regression
analysis. Results: After the exclusion, 356 infants meeting the study criteria
were identified, 26 cases were lost to follow-up, and 330 were eligible at 3
years. The mortality rate was 10% and the incidence of neurological morbidities
was 12%. Logistic regression analysis revealed gestational age at birth
[adjusted odds ratio (aOR) 0.815], and five-minute Apgar scores (aOR 0.521)
were independent predictors for poor outcome. Conclusion: When PPROM was
managed conservatively, 22% of VLBW infants had a poor outcome at corrected age
of 3 years. Early gestational age at birth and low Apgar scores were associated
with poor outcome.