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A predictive neonatal mortality score for women with premature rupture of membranes after 22-27 weeks of gestation

Abstract : Objective: Premature rupture of the membranes (PROM) remains a leading cause of neonatal morbidity. The objectives of the present study were to analyze the outcomes of pregnancies complicated by PROM between 22 and 27(+6) weeks of gestation (WG) and to study antepartum risk factors that might predict neonatal death. Patients and methods: One hundred and seven pregnancies were analyzed over a 3-year period in a tertiary maternity hospital. The collected maternal and neonatal data were used to model and predict the outcome of PROM. Results: Prevalence of PROM (for live births) was 1.08%, and the overall survival rate was 59.8%. From preselected candidate variables, gestational age (GA) at PROM (p = .0002), a positive vaginal culture for pathogenic bacteria (p = .01), primiparity (p = .02), and the quantity of amniotic fluid (p = .03) were included in a multivariable logistic regression analysis. The corresponding adjusted odds ratios [95% confidence interval] were, respectively, 0.91 [0.87-0.96], 11.08 [1.65-74.42], 0.55 [0.33-0.91], and 0.97 [0.95-0.99]. These parameters were used to build a predictive score for neonatal death. Conclusions: The survival rate after PROM at 22-27(+6) weeks of gestation was 59.8%. Our predictive model (built using multivariable logistic regression) may be of value for obstetricians and neonatologists counseling couples after PROM.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03548021
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Soumis le : samedi 29 janvier 2022 - 13:36:10
Dernière modification le : lundi 29 août 2022 - 16:00:22

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Michele Eve Toukam, Marion Luisin, Julien Chevreau, Segolene Lanta-Delmas, Jean Gondry, et al.. A predictive neonatal mortality score for women with premature rupture of membranes after 22-27 weeks of gestation. Journal of Maternal-Fetal & Neonatal Medicine, Taylor & Francis, 2019, 32 (2), pp.258-264. ⟨10.1080/14767058.2017.1378327⟩. ⟨hal-03548021⟩

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