Prognosis of Very Low Birth Weight (VLBW) Infants delivered after Preterm Premature Rupture of Membranes. – Assessment within the First Hour of Life using the PERIDAT-Pre Database 1999–2007

Abstract

Objective: To identify prognostic factors in very low birth weight (VLBW) infants after pPROM within the first hour of life. Methods: This study was a retrospective cohort study including singleton preterm infants <1500g born after pPROM between 1999 and 2007 in a single large tertiary perinatal referral center. Patients with congenital abnormalities, coexisting maternal disease, or intrauterine growth retardation were excluded. A total of 17 obstetric and neonatal factors were evaluated by single-factor and multiple-factor analysis. Study outcomes were neonatal mortality, short term respiratory outcome, chronic lung disease, and severe cerebral morbidity. Results: 300 infants were eligible for inclusion. Ordered by strength of association, the following factors were significantly correlated with at least one of the outcomes included: Gestational age at birth, 5-min APGAR, the first blood gas analysis and arterial blood pressure after NICU admission, anhydramnios, the number of courses of fetal lung maturation, preterm labor, and suspected intrauterine asphyxia. The specificity, sensitivity, PPV and NPV of the logistic regression model was 96%, 38%, 65% and 88% for the outcome of mortality; 98%, 17%, 50% and 92% for the outcome of CLD and 97%, 6%, 20% and 89% for the outcome of severe cerebral morbidity.