Analysis of Obstetric Factors in Adverse Outcomes of Preterm Infants with Preterm Premature Rupture of Membranes
- VernacularTitle:未足月胎膜早破发生早产儿不良结局的产科因素分析
- Author:
Fan WU
1
;
Yifei CAI
1
;
Shaofang HUA
1
Author Information
1. 天津医科大学第二医院产科,天津 300211
- Publication Type:Journal Article
- Keywords:
Preterm premature rupture of the membrane;
Premature;
Adverse outcomes;
Rish factors
- From:
Journal of Practical Obstetrics and Gynecology
2025;41(8):666-671
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the association between adverse outcomes of preterm infants and obstetric factors such as infection,maternal disease and treatment measures in patients with preterm premature rupture of membranes(PPROM),so as to provide more accurate and effective prediction and intervention methods for im-proving maternal and infant prognosis.Methods:A retrospective analysis was conducted on the clinical data of 534 PPROM patients who gave births in the obstetrics department of The Second Hospital of Tianjin Medical Uni-versity from January 1,2018,to August 31,2023.Based on the presence of severe preterm birth complications in premature infants(including bronchopulmonary dysplasia,necrotizing enterocolitis,retinopathy of prematurity,neonatal infectious pneumonia,neonatal respiratory distress syndrome,neonatal hypoxic-ischemic encephalopa-thy,and neonatal sepsis)or death,the patients were divided into two groups:the adverse outcome group(n=121)and the non-adverse outcome group(n=413).The study compared differences between the two groups in general conditions,pregnancy complications and comorbidities,treatment and management,amniotic fluid and pla-cental infections.Logistics regression analysis was used to identify obstetric factors associated with adverse out-comes in preterm infants.Results:Univariate analysis revealed that patients in the adverse outcome group had smaller gestational weeks at delivery,longer intervals between membrane rupture and delivery,and a lower rate of vaginal delivery compared to those in the non-adverse outcome group.They also had a higher proportion of con-current cervical insufficiency,antepartum hemorrhage,hypertensive disorders of pregnancy,and anemia of preg-nancy.The use of prenatal magnesium sulfate and glucocorticoids for fetal lung maturity promotion before delivery was higher,and the effective coverage rates of prophylactic antibiotics was lower.The positive rates of amniotic fluid bacterial culture,the proportion of clinical chorioamnionitis,and histological chorioamnionitis were higher.All of the above differences were statistically significant(P＜0.05).Multivariate analysis revealed that positive amniotic fluid bacterial culture(OR 4.602,95％CI 2.303-9.196,P＜0.05),anemia of pregnancy(OR 4.192,95％CI 2.064-8.510,P＜0.05),and cervical insufficiency(OR 9.435,95％CI 1.138-78.261,P＜0.05)were independ-ent risk factors for adverse outcomes in preterm infants among PPROM patients,while gestational weeks at deliv-ery(OR0.466,95％CI 0.370-0.586,P＜0.05),effective coverage of prophylactic antibiotics before delivery(OR 0.286,95％CI 0.121-0.673,P＜0.05),and treatment for lung maturity promotion(OR 0.225,95％CI 0.107-0.474,P＜0.05)were protective factors for adverse outcomes in premature infants in PPROM patients.Conclu-sions:The adverse outcomes of preterm infants in PPROM patients are closely related to obstetric factors such as infection,maternal diseases,and treatment measures.Among these,positive amniotic fluid bacterial culture,a-nemia during pregnancy,and cervical insufficiency are independent risk factors for adverse outcomes in premature infants in PPROM patients.On the other hand,gestational age at deli very,effective coverage of prenatal antibiot-ics,and pulmonary maturity promotion therapy are protective factors.
