[Effect of premature rupture of membranes on maternal infections and outcome of preterm infants]
- PMID: 28774359
- PMCID: PMC7390056
- DOI: 10.7499/j.issn.1008-8830.2017.08.004
[Effect of premature rupture of membranes on maternal infections and outcome of preterm infants]
Abstract
Objective: To investigate the effect of premature rupture of membranes (PROM) on maternal infections and outcome of preterm infants.
Methods: A total of 441 preterm infants and 387 mothers were enrolled as subjects. According to the presence or absence of PROM, the mothers were divided into non-PROM group with 104 mothers, PROM duration <72 hours group with 90 mothers, and PROM duration ≥72 hours group with 193 mothers. The three groups were compared in terms of clinical features of mothers and infants and complications.
Results: Compared with the control group and the PROM duration <72 hours group, the PROM duration ≥72 hours group had significantly higher maternal age, incidence rate of umbilical vasculitis, and rate of antibiotic use; the PROM duration ≥72 hours group had a significantly higher incidence rate of moderate-to-severe chorioamnionitis than the control group (P<0.05), while there was no significant difference between the PROM duration ≥72 hours group and the PROM duration <72 hours group (P>0.05). Compared with the control group and the PROM duration <72 hours group, the PROM duration ≥72 hours group had significantly higher incidence rates of pneumonia and intracranial hemorrhage in preterm infants; the PROM duration ≥72 hours group had a significantly higher incidence rate of congenital infection and a significantly longer mean length of hospital stay compared with the control group (P<0.05), while there were no significant differences between the PROM duration ≥72 hours group and the PROM duration <72 hours group (P>0.05). The multivariate analysis showed that PROM duration ≥72 hours was an independent risk factors for pneumonia (OR=2.200, 95%CI: 1.386-3.492) and intracranial hemorrhage (OR=2.331, 95%CI: 1.420-3.827) in preterm infants.
Conclusions: PROM duration ≥72 hours significantly increases the risk of placental infection in mothers and it is an independent risk factor for pneumonia and intracranial hemorrhage in preterm infants.
目的: 探讨胎膜早破（PROM）对孕母感染及早产儿结局的影响。
方法: 以441例早产儿及其母亲（387例）为研究对象，根据孕母是否胎膜早破分为对照组（无PROM，104例），PROM时间 < 72 h组（90例）及≥72 h组（193例）。比较各组母、婴的临床特点及并发症差异。
结果: 破膜时间≥72 h组孕母的年龄、脐血管炎发生率以及抗生素应用高于对照组和破膜时间 < 72 h组（P < 0.05）；中-重度绒毛膜羊膜炎的发生率高于对照组（P < 0.05），但与 < 72 h组的差异无统计学意义（P > 0.05）。破膜时间≥72 h组早产儿肺炎、颅内出血的发生率高于对照组和破膜时间 < 72 h组（P < 0.01）；先天性感染的发生率、住院天数高于对照组（P < 0.05），但与 < 72 h组的差异无统计学意义（P > 0.05）。多因素回归分析显示，破膜时间≥72 h是早产儿发生肺炎（P < 0.05）及颅内出血（P < 0.05）的独立危险因素。
结论: 破膜时间≥72 h使孕母胎盘炎症发生风险增加，而且与早产儿肺炎、颅内出血发生相关。
References
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- Zhou Q, Zhang W, Xu H, et al. Risk factors for preterm premature rupture of membranes in Chinese women from urban cities. https://www.researchgate.net/profile/Shufeng_Zhou/publication/264791200_... In J Gynaecol Obset. 2014;127(3):254–259. - PubMed
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- 张 瑞雪, 杨 海澜, 籍 静茹. 611例胎膜早破危险因素及妊娠结局的临床回顾性分析. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHFY201401012.htm 中华妇幼临床医学杂志(电子版) 2014;10(1):53–56.
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- 李 玲, 吴 金芝, 李 萍, et al. 未足月胎膜早破潜伏期对母婴结局的影响. http://www.cnki.com.cn/Article/CJFDTOTAL-HZZZ201213021.htm 中山大学学报(医学科学版) 2013;34(4):590–595.
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