OBJECTIVE: To determined the significant clinical variables associated with neonatal infection in prelabor rupture of the membranes at term.

METHODS: This was a retrospective cohort study of all patients with prelabor rupture of membranes at term. Inclusion criteria were as follows: singleton gestation, cephalic presentation, gestational age > 37 weeks, and rupture membranes. Clinical variables evaluated included the following: cervical dilatation on the admission, Bishop's score, amniotic fluid characteristics  during labor, use of oxytocin for induction/ augmentation of labor, electronic fetal monitoring during labor, total number of internal examinations (IE) done, time interval from PROM to delivery, time interval from active labor to delivery, and manner of delivery. Outcome measure was neonatal infection, both probable and definite neonatal infection.

RESULTS: The incidence of neonatal infection among 28 cases of term PROM in this study was 39%. Bishop's score, total number of internal examination done, time interval from PROM to delivery and time interval from active labor to delivery showed nearly statistically significant association with neonatal infection in the background that all cases underwent labor induction or augmentation and were given antibiotic prophylaxis. On multiple logistics regression analysis, only time interval from PROM to delivery showed statistically significant association with neonatal infection, OR 1.58, 95% CI 1.01-2.47.

CONCLUSION: When the clinical variables are analyzed all together, only the time interval from PROM to delivery showed statistically significant association with neonatal infection, suggesting that a time interval of >24 hours from PROM to delivery renders the neonates at about 1.58 times at increased risk of neonatal infection.