Abstract | OBJECTIVE: METHODS: A retrospective case-control study of 95 preterm infants with the diagnosis of PVL and 245 healthy controls matched for gestational age. A total of 52 antenatal, intrapartum and neonatal characteristics were studied by univariate methods and logistic regression. RESULTS: Preterm premature rupture of membranes ( PPROM) (odds ratio 2.1 [95% CI 1.3-3.4], P=.003), gestational age at PPROM (P=.025), prolonged rupture of membranes (P<.0001), administration of tocolytic agents (1.8 [1.1-3.0], P=.019) and antibiotics (1.9 [1.2-3.1], P=.008) were associated with PVL. The use of tocolytic agents >24 h (P=.008), prolonged latency between the increase in maternal leukocyte count and birth (P=.034), spontaneous onset of labor (1.8 [1.0-2.9], P=.026), vaginal delivery (1.7 [1.1-2.8], P=.029) and male gender (1.5 [1.0-2.0], P=.04) were found more frequently in PVL cases. Preeclampsia (0.4 [0.1-0.9], P=.034), hypertension at booking (P=.009), sonographic IUGR (P=.020), abnormal blood flow of the umbilical artery (P=.032) and cesarean section without labor (0.5 [0.3-0.8], P=.006) were found less frequently. In logistic regression analysis, prolonged rupture of the membranes ( P=.748), preeclampsia (P=.973), the use of antibiotics (P=.617) and beta- sympathomimetic tocolytic agents (P=.563) lost statistical significance, whereas birth weight (P=.036) became significant. CONCLUSION:
PPROM and prolonged rupture of the membranes may provoke adverse effects on the neurodevelopmental outcome of the preterm fetus. These findings may have implications on the obstetric management of PPROM beyond 30 weeks of gestation. Cesarean section without labor was less likely associated with the diagnosis of PVL.
|
Authors | Margit Bauer, Christa Fast, Josef Haas, Bernhard Resch, Uwe Lang, Barbara Pertl |
Journal | Early human development
(Early Hum Dev)
Vol. 85
Issue 3
Pg. 163-9
(Mar 2009)
ISSN: 1872-6232 [Electronic] Ireland |
PMID | 18783900
(Publication Type: Journal Article)
|
Topics |
- Case-Control Studies
- Female
- Fetal Membranes, Premature Rupture
- Humans
- Infant, Newborn
- Infant, Premature
- Leukomalacia, Periventricular
(etiology)
- Pregnancy
- Retrospective Studies
- Risk Factors
|