For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
8
views
27
references
 Top references
cited by
15
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      69
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Risk Factors and Outcomes of Preterm Premature Rupture of Membranes in a Cohort of 6968 Pregnant Women Prospectively Recruited

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          We revisited risk factors and outcomes related to the preterm premature rupture of membranes (PPROM). A total of 7866 pregnant women were recruited during 5 years at their first prenatal visit to the perinatal clinic of the institution. We compared three groups (women without prematurity, women with spontaneous preterm labor with intact membranes (sPL with IM), women with PPROM) regarding 60 criteria about characteristics, lifestyle, medical, gynecological, obstetrical history of mothers, medication during pregnancy, events at delivery, and complications in neonates. Logistic regression analyses adjusting for potential confounding factors were used. Of the 6968 women selected, 189 (2.8%) presented a PPROM, and 225 (3.2%) an sPL with IM. The specific risk factors for PPROM were body mass index (BMI) <18.5 kg/m 2 (adjusted odds ratio, aOR: 2.00 (1.09–3.67)), history of PPROM (aOR: 2.75 (1.19–6.36)), nulliparity (aOR: 2.52 (1.77–3.60)), gestational diabetes (aOR: 1.87 (1.16–2.99)), and low level of education (aOR: 2.39 (1.20–4.78)). The complications associated with PPROM were abruption placentae, cesarean, APGAR 5′ <4, birth weight <2500 g, stillbirth, neonatal jaundice, and hospitalization of mother and neonates. All these complications were also associated with sPL with IM. Our study confirms some of the risk factors of PPROM and highlights a new one: gestational diabetes. Outcomes of PPROM are related to prematurity.

          Related collections

          Most cited references27

          • Record: found
          • Abstract: found
          • Article: not found

          Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes.

          Roberto Romero, Jezid Miranda, Piya Chaemsaithong … (2015)
          The objectives of this study were to: (1) determine the amniotic fluid (AF) microbiology of patients with preterm prelabor rupture of membranes (PROM); and (2) examine the relationship between intra-amniotic inflammation with and without microorganisms (sterile inflammation) and adverse pregnancy outcomes in patients with preterm PROM.
          Article 0 comments Cited 132 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found
            Is Open Access

            Mid-trimester preterm premature rupture of membranes (PPROM): etiology, diagnosis, classification, international recommendations of treatment options and outcome

            Gregor Seliger, Jörg Buchmann, Yuri Naberezhnev … (2018)
            Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%–0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long- and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines. Activation of matrix metalloproteinases (MMP) have been implicated in the mechanism of PPROM. The propagation of bacteria is an important contributing factor not only in PPROM, but also in adverse neonatal and maternal outcomes after PPROM. Inflammatory mediators likely play a causative role in both disruption of fetal membrane integrity and activation of uterine contraction. The “classic PPROM” with oligo/an-hydramnion is associated with a short latency period and worse neonatal outcome compared to similar gestational aged neonates delivered without antecedent PPROM. The “high PPROM” syndrome is defined as a defect of the chorio-amniotic membranes, which is not located over the internal cervical os. It may be associated with either a normal or reduced amount of amniotic fluid. It may explain why sensitive biochemical tests such as the Amniosure (PAMG-1) or IGFBP-1/alpha fetoprotein test can have a positive result without other signs of overt ROM such as fluid leakage with Valsalva. The membrane defect following fetoscopy also fulfils the criteria for “high PPROM” syndrome. In some cases, the rupture of only one membrane – either the chorionic or amniotic membrane, resulting in “pre-PPROM” could precede “classic PPROM” or “high PPROM”. The diagnosis of PPROM is classically established by identification of nitrazine positive, fern positive watery leakage from the cervical canal observed during in specula investigation. Other more recent diagnostic tests include the vaginal swab assay for placental alpha macroglobulin-1 test or AFP and IGFBP1. In some rare cases amniocentesis and infusion of indigo carmine has been used to confirm the diagnosis of PPROM. The management of the PPROM requires balancing the potential neonatal benefits from prolongation of the pregnancy with the risk of intra-amniotic infection and its consequences for the mother and infant. Close monitoring for signs of chorioamnionitis (e.g. body temperature, CTG, CRP, leucocytes, IL-6, procalcitonine, amniotic fluid examinations) is necessary to minimize the risk of neonatal and maternal complications. In addition to delayed delivery, broad spectrum antibiotics of penicillin or cephalosporin group and/or macrolide and corticosteroids have been show to improve neonatal outcome [reducing risk of chorioamnionitis (average risk ratio (RR)=0.66), neonatal infections (RR=0.67) and abnormal ultrasound scan of neonatal brain (RR=0.67)]. The positive effect of continuous amnioinfusion through the subcutaneously implanted perinatal port system with amniotic fluid like hypo-osmotic solution in “classic PPROM” less than 28/0 weeks’ gestation shows promise but must be proved in future prospective randomized studies. Systemic antibiotics administration in “pre-PPROM” without infection and hospitalization are also of questionable benefit and needs to be further evaluated in well-designed randomized prospective studies to evaluate if it is associated with any neonatal benefit as well as the relationship to possible adverse effect of antibiotics on to fetal development and neurological outcome.
            Article 0 comments Cited 56 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Risk factors for preterm birth subtypes.

              R Lapinski, C Craig Blackmore, Ross Berkowitz … (1998)
              To assess epidemiologic risk factors for preterm birth subcategories in an urban population, we undertook a study of 31,107 singleton livebirths that took place at Mount Sinai Hospital in New York City between 1986 and 1994. We subdivided the preterm births into preterm premature rupture of the membranes, preterm labor, and medically induced births. We obtained information regarding the preterm subtypes and their epidemiologic risk factors from a computerized perinatal database. Adjusted odds ratios showed an increased risk for all three preterm birth subtypes in women who were black (1.9 for preterm premature rupture of membranes, 2.1 for preterm labor, and 1.7 for medically induced births) or Hispanic (1.7 for preterm premature rupture of membranes, 1.9 for preterm labor, and 1.6 for medically induced births), those who had had a previous preterm birth (3.2 for preterm premature rupture of membranes, 4.5 for preterm labor, and 3.3 for medically induced births), those who began prenatal care after the first trimester ( 1.4 for preterm premature rupture of membranes, 1.3 for preterm labor, and 1.3 for medically induced births), women who had been exposed to diethylstilbestrol in utero (3.1 for preterm premature rupture of membranes, 4.1 for preterm labor, and 3.7 for medically induced births), patients with preexisting diabetes mellitus (2.2 for preterm premature rupture of membranes, 2.4 for preterm labor, and 9.5 for medically induced births), and those with antepartum bleeding (2.8 for preterm premature rupture of membranes, 3.6 for preterm labor, and 3.7 for medically induced births). Other sociodemographic, constitutional, life-style, and obstetrical characteristics differed across the groups. Variation in some of the risk factors among the preterm subtypes implies that epidemiologic assessment of the more specific outcomes would be advisable.
              Article 0 comments Cited 42 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): J Clin Med
                Journal ID (iso-abbrev): J Clin Med
                Journal ID (publisher-id): jcm
                Title: Journal of Clinical Medicine
                Publisher: MDPI
                ISSN (Electronic): 2077-0383
                Publication date (Electronic): 15 November 2019
                Publication date Collection: November 2019
                Volume: 8
                Issue: 11
                Electronic Location Identifier: 1987
                Affiliations
                [1 ]Biochemistry and Molecular Genetic Department, CHU Clermont-Ferrand, Faculty of Medicine, Université Clermont-Auvergne, CNRS 6293, INSERM 1103, GReD, 63000 Clermont-Ferrand, France; vsapin@ 123456chu-clermontferrand.fr
                [2 ]Department of Molecular Biology, Medical biochemistry and Pathology, Faculty of Medicine, Centre de recherche du CHU de Québec-Université Laval, Québec City, QC G1V 0A6, Canada; jean-claude.forest@ 123456chudequebec.ca (J.-C.F.); yves.giguere@ 123456crchudequebec.ulaval.ca (Y.G.)
                [3 ]Faculty of Medicine, Université Clermont-Auvergne, CNRS 6293, INSERM 1103, GReD, 63000 Clermont-Ferrand, France; loic.blanchon@ 123456uca.fr
                [4 ]Department of Obstetrics, Gynecology and Reproduction, Faculty of Medicine, Université Laval, Québec City, QC G1V 0A6, Canada; Emmanuel.bujold@ 123456crchudequebec.ulaval.ca
                [5 ]Biostatistics Unit (DRCI), CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; bpereira@ 123456chu-clermontferrand.fr
                [6 ]Centre de recherche du CHU de Québec-Université Laval, Québec City, QC G1L 3L5, Canada; nathalie.bernard@ 123456crchudequebec.ulaval.ca
                [7 ]Department of Obstetrics and Gynecology, CHU Clermont-Ferrand, Faculty of Medicine, Université Clermont-Auvergne, CNRS 6293, INSERM 1103, GReD, 63000 Clermont-Ferrand, France; dgallot@ 123456chu-clermontferrand.fr
                Author notes
                [* ]Correspondence: dbouvier@ 123456chu-clermontferrand.fr ; Tel.: +33-4-73-75-48-82
                Author information
                https://orcid.org/0000-0002-2707-4320
                https://orcid.org/0000-0003-3778-7161
                https://orcid.org/0000-0002-7452-315X
                Article
                Publisher ID: jcm-08-01987
                DOI: 10.3390/jcm8111987
                PMC ID: 6912547
                PubMed ID: 31731659
                SO-VID: 69bb238f-6b4e-425a-a1b2-efa49e6c9318
                Copyright © © 2019 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 03 November 2019
                Date accepted : 13 November 2019
                Categories
                Subject: Article

                Keywords: pprom,risk factors,outcomes,gestational diabetes
                Data availability:
                Keywords: pprom, risk factors, outcomes, gestational diabetes

                Comments

                Comment on this article

                scite_

                Similar content69

                See all similar

                Cited by15

                See all cited by

                Most referenced authors460

                See all reference authors