Effect of labor on infant morbidity and mortality with preterm premature rupture of membranes: United States population- based study
Section snippets
Materials and methods
Data were derived from the national linked Perinatal Mortality data files assembled by the National Center for Health Statistics. Between 1995 and 1997, there were 11,436,020 singleton live births in the United States. Among 242,392 singleton live births delivered between 23 and 32 completed weeks’ gestation, 39,251 (16.2%) had PROM, defined as rupture of membranes at least 12 hours before onset of labor. Labor was considered present if the birth record contained the indications tocolysis;
Results
Among 34,594 women who met study criteria, 73.4% (n = 25,382) were in labor before delivery, and 79.8% (n = 27,591) delivered infants in cephalic presentation. The demographic, obstetric, and infant characteristics of women who did and did not labor are presented in Table 1. The rates of infant death, RDS, assisted ventilation, and seizures were 11.6%, 15.1%, 25.9%, and 0.2%, respectively.
Risks and RR for infant death, RDS, assisted ventilation, and seizures for labored compared with nonlabored
Discussion
This study suggests that labor has an adverse effect on outcomes in preterm infants delivered by women with PROM. Infants with low or borderline reserve, (SGA) appear particularly vulnerable to effects of labor, manifested as greater risk of death particularly in the early neonatal period. The higher mortality rate in those infants might explain their lower risk of pulmonary complications, because fewer survive the early neonatal period. However, additional studies are needed to clarify the
References (16)
- et al.
The relationship between labor and route of delivery in the preterm infant
Am J Obstet Gynecol
(1988) - et al.
The effect of cesarean section on intraventricular hemorrhage in the preterm infant
Am J Obstet Gynecol
(1992) - et al.
Uterine contractility and regional blood flow responses to oxytocin and prostaglandin E2 in pregnant rhesus monkeys
Am J Obstet Gynecol
(1975) - et al.
Do survival and morbidity of very-low-birth-weight infants vary according to the primary pregnancy complication that results in preterm delivery?
Am J Obstet Gynecol
(1993) - et al.
Mode of delivery in the low birthweight fetusDelivery by cesarean section independent of fetal lie versus vaginal delivery in vertex presentation
Acta Obstet Gynecol Scand
(1985) - et al.
The effect of cesarean delivery on birth outcome in very low birth weight infants
Obstet Gynecol
(1991) - et al.
The effect of mode of delivery on neonatal mortality in very low birthweight infants born in Victoria, AustraliaCaesarean section is associated with increased survival in breech-presenting, but not vertex-presenting infants
Paediatr Perinat Epidemiol
(1997) - et al.
Revised US certificate of birth-new opportunities for research on birth outcome
Birth
(1989)